A user of cannabis (marijuana) may develop a cardiac arrhythmia, which sometimes can be life-threatening. It is important to carefully evaluate a cannabis-using patient who presents with chest pain or unexplained syncope.
Pathophysiology: cannabis use can result in tachycardia and a rise in blood pressure due to sympathetic nervous system stimulation and parasympathetic nervous system inhibition
Findings that have been reported:
(1) change in heart rate (bradycardia or tachycardia)
(2) atrial fibrillation
(3) atrial flutter
(4) atrioventricular block
(5) premature ventricular contractions
(6) premature atrial contractions
(7) ventricular fibrillation
(8) ST segment elevation
(9) asystole or cardiac arrest
It is important to exclude other causes of cardiac arrhythmias before making a specific diagnosis of cannabis-related arrhythmia:
(1) other substances, especially methamphetamine, cocaine or other stimulants
(2) underlying heart disease, especially in older adults
