Cannabis, Collaterals, and Coronary Occlusion

A 51-year-old gentleman, who regularly smoked cannabis, presented with chest pain and diaphoresis. He was haemodynamically stable. ECG showed ST depression, inferiorly, and 1 mm ST elevation in lead aVR. Emergent coronary angiography showed thrombotic occlusion of the left main coronary artery (LMCA...

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Main Authors: Kalpa De Silva, Divaka Perera
Format: Article
Language:English
Published: Wiley 2011-01-01
Series:Case Reports in Cardiology
Online Access:http://dx.doi.org/10.1155/2011/469850
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author Kalpa De Silva
Divaka Perera
author_facet Kalpa De Silva
Divaka Perera
author_sort Kalpa De Silva
collection DOAJ
description A 51-year-old gentleman, who regularly smoked cannabis, presented with chest pain and diaphoresis. He was haemodynamically stable. ECG showed ST depression, inferiorly, and 1 mm ST elevation in lead aVR. Emergent coronary angiography showed thrombotic occlusion of the left main coronary artery (LMCA), the dominant RCA provided Rentrop grade II collaterals to the LAD. The LMCA was successfully reopened by deployment of a bare-metal stent. Animal heart models suggest that endogenous cannibinoids may cause ischaemic preconditioning. This case suggests that the severity of ischaemia, and hence ECG changes and haemodynamic consequences following an acute occlusion of the LMCA, can be ameliorated by coronary collateralisation and possibly by preconditioning of the myocardium.
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spelling doaj-art-a3c8066c5b8a42a198a3da6a09b579892025-08-20T02:20:21ZengWileyCase Reports in Cardiology2090-64042090-64122011-01-01201110.1155/2011/469850469850Cannabis, Collaterals, and Coronary OcclusionKalpa De Silva0Divaka Perera1Cardiovascular Division, Rayne Institute, St Thomas' Hospital, London SE1 7EH, UKCardiovascular Division, Rayne Institute, St Thomas' Hospital, London SE1 7EH, UKA 51-year-old gentleman, who regularly smoked cannabis, presented with chest pain and diaphoresis. He was haemodynamically stable. ECG showed ST depression, inferiorly, and 1 mm ST elevation in lead aVR. Emergent coronary angiography showed thrombotic occlusion of the left main coronary artery (LMCA), the dominant RCA provided Rentrop grade II collaterals to the LAD. The LMCA was successfully reopened by deployment of a bare-metal stent. Animal heart models suggest that endogenous cannibinoids may cause ischaemic preconditioning. This case suggests that the severity of ischaemia, and hence ECG changes and haemodynamic consequences following an acute occlusion of the LMCA, can be ameliorated by coronary collateralisation and possibly by preconditioning of the myocardium.http://dx.doi.org/10.1155/2011/469850
spellingShingle Kalpa De Silva
Divaka Perera
Cannabis, Collaterals, and Coronary Occlusion
Case Reports in Cardiology
title Cannabis, Collaterals, and Coronary Occlusion
title_full Cannabis, Collaterals, and Coronary Occlusion
title_fullStr Cannabis, Collaterals, and Coronary Occlusion
title_full_unstemmed Cannabis, Collaterals, and Coronary Occlusion
title_short Cannabis, Collaterals, and Coronary Occlusion
title_sort cannabis collaterals and coronary occlusion
url http://dx.doi.org/10.1155/2011/469850
work_keys_str_mv AT kalpadesilva cannabiscollateralsandcoronaryocclusion
AT divakaperera cannabiscollateralsandcoronaryocclusion