Abstract
Wellens syndrome is a rare variant of acute coronary syndrome (ACS) that often heralds an impending large anterior wall myocardial infarction. We present the case of a young male with no traditional coronary artery disease (CAD) risk factors. Despite only minimally elevated troponin levels, the patient's smoking history, serial electrocardiogram (ECG) changes, and the emerging evidence linking cannabis use to cardiovascular risk contributed to the timely diagnosis of Wellens syndrome. Although cannabis is increasingly accepted for medical and recreational use, growing concerns have been raised about its potential adverse cardiovascular effects. This case highlights the importance of early identification and prompt intervention. In Wellens syndrome, a conservative approach is associated with poor outcomes, making the decision to proceed with an invasive strategy critical. Understanding the association between cannabis use and myocardial infarction may shape future medical management as cannabis consumption continues to rise.