Journal Article

Acute myocardial infarction, associated with the use of a synthetic adamantyl-cannabinoid: a case report

McIlroy, Graham, Ford, Loretta, Khan, Jawad M.

2016

Overview

Background “Legal highs” are novel psychoactive substances that have evaded statutory control. Synthetic cannabinoid compounds with adamantane moieties have recently been identified, which have high potency at target receptors and are undetectable on conventional toxicology testing. However, little is known about any harmful effects, and their potential to cause serious ill health. We describe a case of myocardial infarction following the use of this class of drug. Case presentation We report the case of a 39-year-old man admitted after an out-of-hospital cardiac arrest, in whom ECG and elevated cardiac enzymes confirmed ST-elevation myocardial infarction. Normal coronary perfusion was restored after thrombectomy and coronary artery stenting. In the hours preceding his admission, the patient is known to have consumed the legal high product “Black Mamba”. Subsequent urine testing confirmed the presence of an adamantyl-group synthetic cannabinoid, whilst cannabis, cocaine, amphetamines and other drugs of abuse were not detected. Conclusion The use of legal highs is being increasingly recognised, but the chemical compositions and physiological effects of these drugs are poorly characterised and are continually changing. Synthetic cannabinoids, rarely identified on toxicological testing, can be linked to serious adverse cardiovascular events. This case highlights the importance of testing for novel psychoactive compounds, and recognising their potential to cause life-threatening conditions.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V
• Subject: Adamantane - administration & dosage / Adamantane - toxicity / Adamantane - urine / Administration, Inhalation / Adult / Analysis / Biomedical and Life Sciences / Biomedicine / Cannabinoids / Cannabinoids - administration & dosage / Cannabinoids - toxicity / Cannabinoids - urine / Cardiovascular disease / Case Report / Consent / Coronary vessels / Designer Drugs - administration & dosage / Designer Drugs - analysis / Designer Drugs - toxicity / Diagnosis, Differential / Drug use / Electrocardiogram / Electrocardiography / Emergency Medical Services / England / Enzymes / Health services / Heart attack / Heart attacks / Hospitals / Humans / Inhalant Abuse - diagnosis / Inhalant Abuse - physiopathology / Inhalant Abuse - urine / Male / Marijuana / Medical imaging / Myocardial infarction / Myocardial Infarction - etiology / Myocardial Infarction - therapy / Patients / Pharmacology/Toxicology / Physiological aspects / Psychotropic Drugs - administration & dosage / Psychotropic Drugs - toxicity / Psychotropic Drugs - urine / Stents / Thrombosis / Toxicokinetics / Toxicology / Treatment Outcome / Urine