An Unusual Case of Ventricular Tachycardia in a Young Patient Associated with Cannabis Use

Abstract

Marijuana has become the most widely used illicit drug in the United States. Approximately 43.5 million Americans aged 12 or above have reported the use of marijuana in the last year. The use of cannabinoids and its relationship with cardiac effects are not well known. Many types of arrhythmias have been noted with the use of cannabis products with atrial fibrillation being the most common arrhythmia associated with the use of cannabis. We present a case of a 36-year-old male who presented with pounding chest pain, dyspnea, and diaphoresis following marijuana use. He was found to be in ventricular tachycardia which responded to amiodarone. Workup done was negative for any structural disease, and cardiac catheterization was negative for coronary artery disease. He was ultimately discharged on metoprolol. In this report, we focus on how marijuana can be associated with many arrhythmias including ventricular tachycardia with focus on mechanisms by which it can occur. We believe a detailed social history with screening for cannabis use can identify more cases of arrhythmias that can be potentially associated with marijuana use.

Torsades de Pointes due to Excessive Marijuana Use in a Susceptible Patient

“…THC has been associated with different types of ventricular arrhythmias, including VF from QTc prolongation or Brugada syndrome and monomorphic VT attributed to ischemia [3,6,7]. This case highlights the importance of pharmacogenomics in the pathophysiology of arrhythmia associated with the relatively common practice of THC dabbing.…”

Acute Cardiovascular and Cardiorespiratory Effects of JWH-018 in Awake and Freely Moving Mice: Mechanism of Action and Possible Antidotal Interventions?

“…Differently from mice, the most common cardiac symptom reported following SCs use is tachycardia, due to different sympathovagal responses probably caused by the lower dosage taken [16,63]. Indeed, two clinical cases reported that treatment with amiodarone after cannabis or SCs assumption was effective to regularize cardiac rhythm and resolve tachycardia [64,65] due to its direct effect on sinus-atrial node frequency. Likewise, amiodarone regularized all HR changes (arrhythmias and tachycardia) induced by JWH-018 on mice [21].…”

Širdies Aritmijos Ir Kanapių Vartojimas

“…Didesnės kanapių dozės stimuliuoja parasimpatinę ANS, ilgėja veikimo potencialo ir prieširdžių refrakterinis periodas, galimos macro-reentry aritmijos, įvairios bradiaritmijos, silpno sinusinio mazgo sindromas (SSMS), pauzės su sinkopėmis, AV blokados [1, 15,[29][30][31][32]. Aritmijų patogenezėje svarbi ir kanapių vartojimo sąlygota miokardo išemija, padidėjęs deguonies poreikis, trombocitų aktyvacija [1,20,[33][34][35]. Tiriant su kanapių ir sintetinių kanabinoidų vartojimu susijusius EKG pakitimus, pastebėta didesnė P dantelio amplitudė, ilgesnė P bangos ir QRS komplekso trukmė, žemesnis T dantelis, ilgesnė QT bei QTc trukmė [19,36,37].…”

“…KVS pacientų su aritmija grupėje 7,8% patyrė PP, 7,5% SkT, 4,4% SVT 4,4%, 3,7% SkV 3,7%, 2,5% SSMS, 1,6 % trečio laipsnio AV mazgo blokadą [13]. Aritmijos kanapių vartotojams gali pasireikšti sinkopėmis, širdies plakimu, sąmonės sutrikimu, krūtinės skausmu, bendru silpnumu [15,25,[29][30][31][32][34][35][36]. Aprašyti su kanapių ar kanabinoidų vartojimu susijusių aritmijų atvejai, kai išsivystė gyvybei pavojingos skilvelinės aritmijos, kardiogeninis šokas, staigi mirtis arba laidumo sutrikimai, kai buvo reikalinga širdies stimuliatoriaus implantacija [6,15,25,30,32].…”