Nitrous Oxide Use Precipitates Pulmonary Embolism: A Case Report
N. Nguyen, Jessica Cao, Deborah Carlson, Lynn Kong, Graal Diaz
Cureus September 1, 2024 DOI: 10.7759/cureus.69347 via Semantic Scholar
Summary
AI-generated from the abstractA healthy patient who used nitrous oxide recreationally every day developed venous thromboembolism, including pulmonary emboli. Nitrous oxide interferes with vitamin B12, causing hyperhomocysteinemia, which can make blood more prone to clotting. Anticoagulation therapy led to significant improvement in the pulmonary emboli. As recreational nitrous oxide use rises, clinicians should recognize that hyperhomocysteinemia from the drug may create a thrombotic state.
Study at a glance
| Characteristics | Case vignette Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | A healthy patient with venous thromboembolism and recreational nitrous oxide use |
| Intervention | anticoagulation therapy |
| Keywords | Medicine |
| Key finding | Daily recreational nitrous oxide use may precipitate venous thromboembolism through hyperhomocysteinemia. |
Abstract
Nitrous oxide (N2O) has a lengthy history of use as an anesthetic and has recently found popularity as a recreational euphoric hallucinogen. The odorless, colorless, non-flammable gas interferes with Vitamin B12 resulting in a cascade of effects, including hyperhomocysteinemia. It has long been proposed that hyperhomocysteinemia adversely affects the cardiovascular system, producing atherogenic and prothrombotic diseases. In this case vignette, we describe a case in which a healthy patient presented with venous thromboembolism (VTE) that we suspect could have been precipitated by daily and significant recreational use of N2O. Anticoagulation therapy was given, and there was a significant improvement in the pulmonary emboli. As recreational use of N2O increases, it is essential to recognize that hyperhomocysteinemia may also produce a thrombotic state.