A Case of Status Epilepticus and Transient Stress Cardiomyopathy Associated with Smoking the Synthetic Psychoactive Cannabinoid, UR-144

Abstract

Patient: Female, 19-year-oldFinal Diagnosis: Status epilepticus and stress induced cardiomyopathySymptoms: SeizureMedication: —Clinical Procedure: —Specialty: ToxicologyObjective:Unusual clinical courseBackground:Synthetic cannabinoids have a higher affinity for the cannabinoid receptors CB1 and CB2 than natural cannabinoids. Their use can be associated with cardiovascular disease and neurological complications. A case is reported of status epilepticus and stress cardiomyopathy following the recreational use of the synthetic cannabinoid, UR-144.Case Report:A 19-year-old woman presented to the emergency department in status epilepticus after smoking the synthetic cannabinoid known as ‘space’. Recurring seizure activity was controlled after three hours. On hospital day 3, the patient developed severe biventricular failure. Cardiac magnetic resonance imaging (MRI) confirmed the diagnosis of stress cardiomyopathy. A comprehensive urine drug screen was performed using gas chromatography-mass spectrometry (GC-MS), which was positive for UR-144, or (1-pentyl-1H-indol-3-yl) (2,2,3,3-tetramethylcyclopropyl)-methanone, and negative for all other illicit recreational drugs. The patient improved at one week following admission, with a left ventricular ejection fraction (LVEF) of 40%. She was discharged home on hospital day 10.Conclusions:The use of the synthetic cannabinoid, UR-144, may be associated with prolonged status epilepticus and stress cardiomyopathy. Physicians should be aware of these potentially lethal complications associated with the recreational use of this and other illicit synthetic cannabinoids.

Stress Cardiomyopathy Triggered by Status Epilepticus Secondary to Herpes Simplex Virus Encephalitis: Case Report and Literature Review

“…In this literature review, it was found that stress cardiomyopathy is more common after convulsive status epilepticus [ 9 - 24 ]. A STAT echocardiogram is very important in order to assess the myocardial injury and to have baseline imaging results.…”

“…The time to resolution also remains unknown, as we do not know the exact left ventricular recovery mechanism, therefore close follow-up with repeat TTE is important. From our review, it was found that the time of normalization ranges from four days to about eight weeks [ 9 - 24 ]. The prevalence of SCM secondary to SE is much more common in women, especially postmenopausal women [ 9 - 24 ].…”

“…From our review, it was found that the time of normalization ranges from four days to about eight weeks [ 9 - 24 ]. The prevalence of SCM secondary to SE is much more common in women, especially postmenopausal women [ 9 - 24 ]. It is hypothesized that estrogen protects the heart from catecholamines.…”

Cannabis und synthetische Cannabinoide – eine nicht nur radiologische Übersicht

“…o.) [2,11]. Akutes Nierenversagen ist eine weitere Komplikation nach SCRA-Konsum, die von Flankenschmerz, Proteinurie, Hämaturie und auch Rhabdomyolyse begleitet sein kann [52].…”

Cannabinoid Receptor Subtype 2 (CB2R) in a Multitarget Approach: Perspective of an Innovative Strategy in Cancer and Neurodegeneration

“…Several classes of compounds acting as CB2R agonists have been developed in the past years, bearing different scaffolds: dibenzopyran, , oxoquinoline, − naphthyridinone, − quinolinedione alkyloxy-coumarin indole, − indazole imidazopyridine, imidazopyrazine, benzimidazole, , purine, , thiophene, , triazine, , pyridinone, − biphenyl, , proline, , and piperidine . In Figure the most representative and selective known CB2R ligands are reported along with their K i values on CB1R and CB2R.…”