Marijuana, bigeminal premature ventricular contractions and sluggish coronary flow: Are they related?

Premature ventricular contractions (PVCs) and slow coronary flow phenomenon (SCFP) are primarily separate entities. Each one of them has different characteristics and a diverse spectrum of presentation. However, and despite many suggested theories, a comprehensive understanding of the etiology of both of them is still a matter of debate. PVCs, which can be triggered by consuming cannabis (marijuana), and through decreasing the diastolic time (DT), can affect the slow blood flow found in SCFP even more and worsen the clinical picture in patients who have PVCs and SCFP. In this paper, we present a patient who uses marijuana and has PVCs and SCFP, try to address different aspects of PVCs and SCFP, pinpoint any suspected interaction between both of them and the role of marijuana in this context. <Learning objective: (i) PVCs are extra abnormal heartbeats arising in one of the ventricles and disrupting the normal rhythm of the heart. (ii) PVCs are very common and occur in a broad spectrum of the population including those with and without underlying heart disease. (iii) SCFP is an angiographic finding characterized by delayed progression of the contrast injected inside large coronary arteries without any significant CAD. (iv) It has an incidence of 1% among patients who undergo coronary angiography, especially those presenting with acute coronary syndrome. (v) PVCs, which can be triggered by consuming cannabis (marijuana), and throughout decreasing the DT, can affect the slow blood flow found in SCFP even more and worsen the clinical picture in patients who have PVCs and SCFP.>.