Abstract
BACKGROUND: Tetrahydrocannabinol (THC), the psychoactive compound in cannabis, is increasingly used recreationally, especially among young adults. Although often perceived as harmless, emerging evidence links THC to serious cardiovascular complications, including QTc prolongation, ventricular arrhythmias, and sudden cardiac arrest, even in individuals without underlying heart disease.
CASE REPORT: A 26-year-old woman with a history of chronic cannabis use was brought to the Emergency Department (ED) after having a sudden cardiac arrest. Her initial rhythm was ventricular fibrillation, and return of spontaneous circulation was achieved following advanced cardiac life support. An initial electrocardiogram revealed sinus tachycardia with a QTc interval of 483 ms, and a urine drug screen was positive for THC. Cardiac catheterization performed 4 weeks later revealed normal coronary arteries. Her left ventricular ejection fraction, initially reduced at 25-30%, had normalized by the time of catheterization. She sustained hypoxic-ischemic brain injury, requiring prolonged rehabilitation.
CONCLUSIONS: This case highlights the potential for cannabis use to induce life-threatening cardiac arrhythmias, including QTc prolongation, and ventricular fibrillation, even in young adults with no prior cardiovascular risk factors. Clinicians should maintain a high index of suspicion for cannabis-induced cardiotoxicity in similar presentations, particularly as cannabis use becomes more widespread.