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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 (opens in new tab)

Study at a glance

AI-extracted from the abstract
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
Key findings 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.