Introduction: Marijuana is the most commonly used illegal drug worldwide. Despite the overwhelming public perception of the safety of this substance, an increasing number of serious cardiovascular adverse events have been reported in temporal relation to recreational cannabis usage (1).

Case report: 38-year-old African with permanent residence in Split was brought to emergency room (ER) after he was witnessed to having cardiac arrest. That same evening, 15 minutes after he had consumed cannabis, the patient complained about a burning pain in the throat and collapsed. His spouse started the cardiopulmonary resuscitation. Four minutes later, when the ER medics arrived, ventricular fibrillation was recorded which cardioverted with 2DC shocks (200 J). Subsequently, atrial fibrillation was recorded with ST elevation in inferolateral leads. Upon arrival at the hospital, his vital signs were stable. The Glasgow Coma Scale was 6/15; hence he was intubated and ventilated the following 24 hours. Further ECG monitoring showed sinus rhythm without signs of ischemia. The results of coronarography were normal except non-significant changes of the right coronary artery. With echocardiography, we excluded structural cardiac disease. The results of other imaging methods (MSCT aortography, MSCT of abdomen and brain) were normal. The urine screening showed to be positive for cannabinoids, negative for cocaine, opium, amphetamine and methadone. After his fifth day of hospitalization, the patient left hospital treatment willingly with no neurological and cardiovascular sequels.

Conclusion: Cardiac arrest is rare but is one of the possible and potential fatal consequences of cannabis usage. The awareness of this is important taking into account the increasing trend of consumption and possible legalization of this drug.