Accidental Ingestion of Tetrahydrocannabinol-Laced Gummies Causing Bradycardia and First-Degree Atrioventricular Block in a Pediatric Patient: A Case Report

Abstract

An increasing trend of cannabis use places children at risk for the detrimental effects of marijuana. Poison control centers in the United States have been experiencing an upsurge in calls involving marijuana ingestion among children in the past years, specifically in states where marijuana is legal. With marijuana ingestion, neurologic symptoms predominate but cardiovascular manifestations have also been observed. Bradycardia and bradyarrhythmia are both uncommon cardiac manifestations of cannabis ingestion in children. Here, we present the case of a previously healthy two-year-old male with sinus bradycardia and first-degree atrioventricular (AV) block following accidental ingestion of tetrahydrocannabinol-laced gummies. Although bradycardia and first-degree AV block are uncommon after cannabis ingestion in children, clinicians should be aware of these findings and must consider evaluating for marijuana toxicity whenever presented with these acute signs. Prevention is crucial and can be achieved through supervision, parental education, and support.

Asystole in a young child with tetrahydrocannabinol overdose: a case report and review of literature

“…Unlike adult patients with large Δ9-THC exposures who typically present with tachycardia, anxiety, paranoia, and hallucinations, pediatric patients with significant THC exposure may present with significant central nervous system (CNS) depression, ataxia, respiratory depression, apnea, bradycardia, hypotension, and seizures ( Shaker et al, 2023 ; Akpunonu et al, 2021 ; Burrows and Williams, 2019 ; Wong and Baum, 2019 ; Wang et al, 2016 ; Wang et al, 2014 ). Increasing reports of bradycardia and apnea are particularly concerning as the cardiovascular effects of THC are not fully understood ( Idris et al, 2022 ).…”