Abstract:
Background: Cannabis use is increasingly encountered in emergency care, yet its cardiovascular effects are often underrecognized when younger patients present with chest pain, palpitations, syncope, or neurologic symptoms. This review synthesized current evidence and developed a practical emergency-department framework for evaluating suspected cannabis-associated cardiovascular events.
Methods: A structured narrative review of PubMed/MEDLINE and major cardiovascular-society statements was conducted for literature published from January 2010 through June 2026. Search concepts combined cannabis, marijuana, tetrahydrocannabinol, or cannabinoids with myocardial infarction, acute coronary syndrome, arrhythmia, syncope, stroke, hemodynamic effects, and emergency care. Human studies, systematic reviews, and scientific statements addressing acute cardiovascular outcomes were prioritized. Findings were organized according to exposure characteristics, clinical syndrome, co-exposures, baseline cardiovascular vulnerability, diagnostic testing, and disposition.
Results: The literature describes several plausible and clinically relevant cardiovascular presentations after cannabis exposure, including transient tachycardia and blood-pressure changes, myocardial ischemia or infarction, atrial and ventricular dysrhythmias, bradyarrhythmia or syncope, and cerebrovascular events. Higher-risk contexts repeatedly included recent inhalation or high-tetrahydrocannabinol exposure, frequent use, synthetic cannabinoid exposure, concurrent tobacco or stimulant use, and pre-existing ischemic, structural, or electrical heart disease. However, the evidence base remains dominated by observational studies, self-reported exposure, inconsistent product characterization, and residual confounding. No validated emergency-department decision rule was identified. The synthesis therefore yielded a five-domain C-CARD framework: Cannabis exposure characterization; Clinical cardiovascular syndrome identification; Associated co-exposures; Risk substrate; and Directed diagnostics, monitoring, and disposition.
Conclusions: Cannabis exposure should be considered a potential cardiovascular trigger or risk modifier rather than a benign historical detail, particularly in younger patients with otherwise unexplained ischemic, arrhythmic, or syncopal presentations. A standardized exposure history combined with syndrome-based testing may improve recognition while avoiding indiscriminate investigation. Prospective validation of the proposed C-CARD framework is needed before routine clinical adoption.
Biography:
Dr. Sanjeev Sirpal is a physician and public-health researcher with experience in emergency medicine, preventive medicine, population health, and health-policy analysis. His research interests include cardiovascular risk, social determinants of health, emergency-care surveillance, patient safety, and cannabis harm reduction. His interdisciplinary work focuses on translating clinical and population evidence into practical risk-assessment and prevention strategies.
Copyright 2024 Mathews International LLC All Rights Reserved
