Coronary thrombosis and marijuana smoking: a case report and narrative review of the literature

Daniela Marchetti, Angelico Spagnolo, Valentino De Matteis, Laura Filograna, Nadia De Giovanni

Research output: Contribution to journalArticle


We encountered evidence of myocardial infarction due to coronary thrombosis in an autopsy of an occasional marijuana smoker. These findings prompted us to perform a narrative review of the literature to determine when postmortem toxicological tests may support a temporal relationship between marijuana smoking and cardiovascular disease. Toxicological examination showed the presence of Δ-9-tetrahydrocannabinol, its main metabolite and cannabinol in blood and urine. Quali-quantitative analysis revealed that Δ-9-tetrahydrocannabinol was taken within 2 h of onset of cardiovascular symptoms, according to circumstantial data. Postmortem toxicological results must take into account the degradation and postmortem redistribution of analytes. However, for any inference about the specific cardiovascular triggering effect of Δ-9-tetrahydrocannabinol intake, we maintain that cannabinoid analysis in blood samples must be considered an essential requirement to estimate the time of last intake and avoid incomplete documentation. The literature combined with the present case report highlights an association between marijuana use and negative cardiovascular events, although few authors have supported their conclusions with toxicological results. Thus, additional research is needed.
Original languageEnglish
Pages (from-to)57-63
Number of pages7
JournalDrug Testing and Analysis
Publication statusPublished - 2015


  • cardiovascular disease
  • forensic sciences
  • marijuana smoking


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