Abstract
Background
Acute aortic dissection (AD) is a life-threatening condition most frequently seen
in men with an average age >60 years. Risk factors include family history, hypertension
and cigarette smoking. AD has been associated with methamephatamine and cocaine use
but has not previously been associated with the use of marijuana.
Case Report
We report a case of an aortic dissection in a 56-year-old male that occurred while
smoking marijuana. The patient had a family history significant for both aortic aneurysm
and dissection. He developed crushing chest pain, shortness of breath, and diaphoresis
shortly after smoking marijuana from a glass pipe called a “bubbler”. His ECG was
unremarkable as was his chest x-ray and initial labs. CT scan revealed an Aortic dissection
from the aortic root to the internal iliac artery.
Why Should an Emergency Physician Be Aware of This?
The role of cannabis in cardiovascular disorders is complex and not completely understood.
Acute chest pain associated with marijuana use typically raises concern for pneumothorax
or pneumomediastinum. Marijuana has also been associated with hypertension and arrhythmias
and has also been associated with an increased risk of myocardial infarction. However
a link between marijuana and acute aortic dissection has not been previously reported.
As more states legalize medical and recreational marijuana use this is a timely and
important consideration for Emergency physicians evaluating chest pain. Our goal is
to document the temporal relationship of cannabis use and acute aortic dissection
in a recent ED patient.
Keywords
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Article info
Publication history
Published online: May 21, 2019
Accepted:
March 27,
2019
Received in revised form:
March 17,
2019
Received:
April 25,
2018
Identification
Copyright
© 2019 Published by Elsevier Inc.