Recurrent myopericarditis as a complication of Marijuana use

Abstract

Patient: Male, 29Final Diagnosis: MyopericarditisSymptoms: Chest painMedication: IbuprofenClinical Procedure: —Specialty: CardiologyObjective:Unusual clinical courseBackground:Cannabis is the most commonly used illegal substance worldwide and its consumption portends significant side effects. Nowadays, in order to increase its psychotropic effect, various substances are being added constantly to it to promote its potency that might hold toxic effects to different organs including the heart and might lead to other unreported complications such as myopericarditis. Herein, we are presenting a unique case of recurrent myopericarditis after the consumption of contaminated marijuana, an association that has not been reported in literature before.Case Report:A 29-year-old man presented to our institution with pressure-like left-sided chest pain that is aggravated by cough and deep inspiration and relieved by sitting and leaning forward. Examination revealed pericardial rub and workup showed elevated white blood cell count, C-reactive protein and troponin I level of 2.99 ng/ml. ECG upon admission showed ST-segment elevation in the inferior leads with PR-segment depression. Echocardiogram revealed only concentric hypertrophy. Patient was admitted to another institution with similar symptoms 2 months earlier. Patient admitted to using adulterated Marijuana on both occasions prior to hospitalization. Review of medical records from the outside hospital revealed similar ECG and laboratory findings. Treatment with Ibuprofen resulted in resolution of patient’s symptoms and ECG abnormalities.Conclusions:Recurrent myopericarditis in our patient is likely the result of consumption of contaminated Marijuana. Careful history taking in patients presenting with myopericarditis is crucial as it might be the causal link.

Cardiac Ischemia Associated With Marijuana Use in an Adolescent

“…A prior report also notes cardiac inflammation after marijuana use presenting as recurrent myopericarditis in a 29-year-old previously healthy male with pericardial rub, CRP and troponin I elevation, and ECG demonstrated ST-segment elevation and PR-segment depression [12].…”

Ventricular tachycardia revealing drug abuse induced myocarditis: two case reports

“…In contrast, for the second patient, cannabis is likely the responsible drug because of the occasional consumption of cocaine compared to daily use of cannabis, in addition to the absence of cocaine‐related ECG signs 7. However, cannabis is uncommonly reported to be associated with myocarditis 8, 9. The presence of adulterants or contaminants (such as solvents and pesticides) in manufactured modified cannabis could be a possible mechanism responsible for the cardiotoxic effects of cannabis 10.…”

Pediatric Death Due to Myocarditis After Exposure to Cannabis

“… 16 In 2014 Rodríguez-Castro reported a 29-year-old male who had two episodes of myopericarditis several months apart. 17 Each episode occurred within two days of smoking cannabis. 18 In 2016, Tournebize reported a 15-year-old male diagnosed with myocarditis, clinically and by cardiac magnetic resonance imaging, after initiating regular cannabis use eight months earlier.…”