The association of cannabis use and cardiac dysrhythmias: a systematic review

Richards, John R.; Blohm, Eike; Toles, Kara A.; Jarman, Angela F.; Ely, Dylan F.; Elder, Joshua W.

doi:10.1080/15563650.2020.1743847

Cited by 49 publications

(38 citation statements)

References 77 publications

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“…Furthermore, there are case reports involving cannabis consumption associated with acute MI in those with normal coronaries and of young men, usually with underlying structural heart disease that can be brought on by exercise [61]. Another possibility is that cannabis usage may be associated with a higher risk of cardiac dysrhythmias, though rare could potentially be life threatening, as was reported in a recent systematic review [75].…”

Section: Ed Cannabis Presentations Acute Intoxication/overdosementioning

confidence: 96%

The emergency department care of the cannabis and synthetic cannabinoid patient: a narrative review

Takakuwa¹,

Schears

2021

Int J Emerg Med

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Background Cannabis is the most prevalent illegal drug used and the second most common cause of ED drug-related complaints in the USA. Recently, newer more potent strains, concentrated THC products, and consumption methods have become available. Objective Our first objective was to define cannabis use in the USA and provide a summary background on its current preparations, pharmacokinetics, vital sign and physical exam findings, adverse effects, and laboratory testing. Our second objective, using the aforementioned summary as relevant background information, was to present and summarize the care and treatment of the most commonly reported cannabis-related topics relevant to ED physicians. Methods We first performed an extensive literature search of peer-reviewed publications using New PubMed and Cochrane Central Register of Controlled Trials to identify the most commonly reported cannabis-related topics in emergency care. Once the six topic areas were identified, we undertook an extensive narrative literature review for each section of this paper using New PubMed and Cochrane Central Register of Controlled Trials from the inception of the databases to September 30, 2020. Results The six subject areas that were most frequently reported in the medical literature relevant to cannabis-related ED care were acute intoxication/overdose, pediatric exposure, cannabinoid hyperemesis syndrome, cannabis withdrawal, e-cigarette or vaping product use-associated lung injury (EVALI), and synthetic cannabinoids. Conclusion As cannabis becomes more widely available with the adoption of state medical cannabis laws, ED-related cannabis visits will likely rise. While cannabis has historically been considered a relatively safe drug, increased legal and illegal access to newer formulations of higher potency products and consumption methods have altered the management and approach to ED patient care and forced physicians to become more vigilant about recognizing and treating some new cannabis-related life-threatening conditions.

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Section: Ed Cannabis Presentations Acute Intoxication/overdosementioning

confidence: 96%

The emergency department care of the cannabis and synthetic cannabinoid patient: a narrative review

Takakuwa¹,

Schears

2021

Int J Emerg Med

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“…A series of studies that evaluated an oral drug containing pure delta 9-tetrahydrocannabinol (THC) in older adults found mixed results, with some showing a small increase in systolic blood pressure while causing a decrease or no change in heart rate and diastolic blood pressure [16,17], and others reported non-significant changes [18]. Furthermore, a number of retrospective studies done primarily in young individuals showed an association between cannabis use and cardiac arrhythmias [19][20][21][22][23].…”

Section: Introductionmentioning

confidence: 99%

Cannabis is associated with blood pressure reduction in older adults – A 24-hours ambulatory blood pressure monitoring study

Abuhasira

Haviv

Leiba

et al. 2021

European Journal of Internal Medicine

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“…Based on published clinical cases, these conduction abnormalities usually resolve within 24 hours, making permanent pacemaker placement unnecessary. 151 Cardiotoxic effects remain an overall rare event despite widespread use of cannabis. Cannabis potency, cannabinoid ratios, cannabis use patterns, and individual patient pharmacogenetic factors, such as metabolic enzyme expression, likely render a small proportion of cannabis users susceptible.…”

Section: Resultsmentioning

confidence: 99%

Mechanisms for the Risk of Acute Coronary Syndrome and Arrhythmia Associated With Phytogenic and Synthetic Cannabinoid Use

Richards

2020

J Cardiovasc Pharmacol Ther

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Phytogenic cannabinoids from Cannabis sativa and synthetic cannabinoids are commonly used substances for their recreational and medicinal properties. There are increasing reports of cardiotoxicity in close temporal association with cannabinoid use in patients with structurally normal hearts and absence of coronary arterial disease. Associated adverse events include myocardial ischemia, conduction abnormalities, arrhythmias, and sudden death. This review details the effects of phytogenic and synthetic cannabinoids on diverse receptors based on evidence from in vitro, human, and animal studies to establish a molecular basis for these deleterious clinical effects. The synergism between endocannabinoid dysregulation, cannabinoid receptor, and noncannabinoid receptor binding, and impact on cellular ion flux and coronary microvascular circulation is delineated. Pharmacogenetic factors placing certain patients at higher risk for cardiotoxicity are also correlated with the diverse effects of cannabinoids.

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The association of cannabis use and cardiac dysrhythmias: a systematic review

Cited by 49 publications

References 77 publications

The emergency department care of the cannabis and synthetic cannabinoid patient: a narrative review

The emergency department care of the cannabis and synthetic cannabinoid patient: a narrative review

Cannabis is associated with blood pressure reduction in older adults – A 24-hours ambulatory blood pressure monitoring study

Mechanisms for the Risk of Acute Coronary Syndrome and Arrhythmia Associated With Phytogenic and Synthetic Cannabinoid Use

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