Suspected Cannabis-Induced Acute Coronary Syndrome and Advanced Heart block.

We describe a 35-year-old Caribbean-Black male patient with a significant cannabis history who presented with an inferior ST-segment-elevation acute coronary syndrome (STE-ACS), with advanced heart block during active, ongoing cannabis consumption. During primary percutaneous coronary intervention, cineangiography revealed substantial thrombus burden in the first acute marginal branch of the right coronary artery. He successfully underwent aspiration thrombectomy with subsequent angioplasty with a drug-coated balloon and guideline-directed medical therapy, including direct oral anticoagulation. The clinician should be cognizant of the association between ACS and both acute and chronic cannabis consumption.