Cannabis, Collaterals, and Coronary Occlusion. (19th July 2011)

• Record Type: Journal Article
• Authors: De Silva, Kalpa; Perera, Divaka
• Other Names: Castagna Marco T. Academic Editor.; Jim Man-Hong Academic Editor.; Nikus Kjell Academic Editor.; Sarullo Filippo M. Academic Editor.
• Is Part Of: Case reports in cardiology. Volume 2011(2011)
• Publication Date: 2011-07-19
• Subjects: Cardiology -- Periodicals; 616.12005
• DOI: 10.1155/2011/469850
• Languages: English
• ISSNs: 2090-6404

Abstract

Abstract : 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.