eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2020-01-18 8 3 79 82 10.12691/ajmcr-8-3-4 AJMCR2020834 article Krunal H. Patel 1 Pramod Theetha Kariyanna 2 Apoorva Jayarangaiah 3 Nabila Khondakar 3 Madina Abduraimova 3 Samy I. McFarlane Samy.mcfarlane@downstate.edu 3 Department of Internal Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY, USA -11203 Division of Cardiovascular Disease, Department of Internal Medicine, State University of New York, Downstate Medical Center, Brooklyn, N.Y, USA - 11203 Department of Internal Medicine, NYC + HHC Jacobi Medical Center, 1400 Pelham Pkwy S, Bronx, NY, U.S.A- 10461 With the rise of the number of states fully legalizing marijuana, the use of this substance in the United States is at an all-time high. This increasing legalization gives the impression that marijuana is rather safe. However, multiple reports by our groups and others documented serious cardiovascular complications associated with marijuana use ranging from life threatening arrhythmia to myocarditis and myocardial infarction. In this report, we present a case of a 61 year old man presented with left sided typical chest pain shortly after marijuana consumption with the diagnosis of non ST-elevation myocardial infarction (NSTEMI) established based on clinical, EKG and troponin values with eventual cardiac catheterization documenting non-occlusive coronary artery disease with 30% obstruction of the proximal first obtuse marginal artery. We also review the putative pathophysiologic mechanisms of marijuana induced coronary vasospasms, highlighting the implications of these findings in the evaluation and management of cardiac chest pain in marijuana users. http://pubs.sciepub.com/ajmcr/8/3/4/ajmcr-8-3-4.pdf marijuana cannabis myocardial infarction vasospasm