The Impacts of Vaping on the Cardiovascular System: A Systematic Review of Case Reports

Currently, cigarette smoking remains a global epidemic, with approximately one billion tobacco smokers worldwide, despite declines in use. Vaping products have become popular alternatives in recent years to conventional cigarettes. There has been a perception that vaping serves as a "healthier" alternative and has been increasing across all age groups, especially among teenagers and young adults. Vaping and its additives have been shown to have various implications across organ systems, including pulmonary and cardiovascular systems. Meanwhile, additional research efforts are needed to gain insight into the pathophysiology of vaping on cardiovascular disease onset, progression, and outcomes. In order to better understand the body of literature available on the association between vaping and cardiovascular function, a systematic review was conducted, which included case studies of patients engaged in vaping at the time of developing a cardiovascular event. A systematic review was conducted with a total of 20 patients. Only case studies were included to assess the cardiovascular outcomes that were reported with vaping using either nicotine, non-nicotine, or tetrahydrocannabinol (THC)-containing products. Patients were excluded if they orally consumed the vaping liquid and did not smoke the product. Fourteen of the 20 patients assessed were males (70%), five females (25%), and one unspecified sex (5%). The patients varied in age from 13 to 70 years of age, with a mean age of 27.6 years. Vaping history duration ranged from two days to eight years, with a mean of 22.8 months. Fourteen of the 20 patients reported using nicotine-containing vape devices, with an additional two using THC-containing vape products, three using both nicotine and THC-containing vape devices, and one non-nicotine-containing vape device. The results demonstrated that eight of 20 patients presented with chest pain or discomfort and 10 were found in sudden cardiac arrest. Upon resuscitation from cardiac arrest, a variety of arrhythmias were seen, including ventricular tachycardia, ventricular fibrillation, polymorphic ventricular tachycardia, atrial fibrillation, and a prolonged QT segment arrhythmia. The results suggest that vaping likely negatively impacts the cardiovascular system. Further research is warranted, especially as the popularity of vaping continues to rise among younger populations. As vaping continues to rise in popularity, particularly among younger populations, further research is warranted to elucidate its long-term cardiovascular impact.