Acute cannabis intoxication mimicking brugada-like ST segment abnormalities
International Journal of Cardiology
|February 13, 2007
Summary
Heavy marihuana use in a young male caused syncope and Brugada-like ECG changes. These cardiac abnormalities resolved as Tetrahydrocannabinol (THC) levels decreased, suggesting a link between THC and arrhythmias.
Area of Science:
- Cardiology
- Clinical Toxicology
Background:
- Brugada syndrome is a genetic disorder characterized by abnormal ECG findings and an increased risk of ventricular arrhythmias.
- Syncope, or fainting, can result from various underlying medical conditions, including cardiac arrhythmias.
- Marijuana use, particularly heavy use, has been anecdotally linked to various cardiovascular events.
Observation:
- A 19-year-old male presented with syncope following significant marijuana consumption.
- Electrocardiogram (ECG) revealed Brugada-like ST-segment elevation in leads V1 and V2.
- Toxicology reports confirmed markedly elevated levels of Tetrahydrocannabinol (THC).
Findings:
- Echocardiogram showed normal left ventricular function and no structural heart abnormalities.
- The Brugada-like ECG changes resolved as acute intoxication subsided.
- A procainamide challenge test did not provoke recurrence of the ST-segment abnormalities.
- The patient's syncope and ECG changes were attributed to THC intoxication, ruling out vasovagal syncope or structural heart disease.
Implications:
- This case highlights the potential for Tetrahydrocannabinol (THC) to induce transient Brugada-like electrocardiographic changes and syncope in susceptible individuals.
- The findings suggest that THC may possess arrhythmogenic properties, potentially through action potential shortening and vagal hyperstimulation.
- Understanding the cardiac effects of THC is crucial for clinicians managing patients with unexplained syncope or ECG abnormalities, especially in the context of recreational drug use.
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