1. Cardiovascular Manifestations Associated with the Use of Synthetic Cannabinoids Hans Reyes 1 MD, Eder Cativo 1 MD, Marco Ruiz 1 MD, Carissa Dumancas 1 MD, Gerald Pekler 2 MD, Ferdinand Visco 2 MD, Savi Mushiyev 2 MD, Getaw Worku Hassen 3 MD. 1 NYMC, Metropolitan Hospital Center, Department of Medicine, 2 NYMC, Metropolitan Hospital Center, Division of Cardiology, 3 NYMC, Metropolitan Hospital Center, Department of Emergency Medicine.
Introduction
Results
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57 of the 410 patients who self-reported recent use of SC in the ED were admitted as inpatients. 42 out of 57 had cardiovascular manifestations. The mean age among the population was 45 year-old. The main cardiovascular manifestation was sinus bradycardia, which was found in 16 patients. 13 patients were admitted to the Intensive Care Unit or had new EKG changes, the mean age among this group was almost 30 years greater than those who did not, but this finding was not statistically significant.
One patient 33 year-old presented in cardiac arrest after using SC along with amphetamines at the same time. 2 patients of 62 ad 64 year-old had NSTEMI, one with previous history of coronary artery disease with stents and the other patient with cardiac risk factors. No abnormal Echocardiographic findings or malignant arrhythmias were noted. Patients who required intensive care or with new EKG changes had a greater length of stay in the hospital (p=0.049).
Table 1. Demographic and general characteristics
During the past few years, there has been an epidemic of Synthetic Cannabinoid (SC) use in major cities, given its cost and marijuana-like effects. The central nervous system and the cardiovascular system are predominantly affected. Endocannabinoids affect contractility and Ca+2 signaling through their affinity for the CB1 and CB2 receptors.
Hypothesis
The principal cardiovascular effect associated with SC use is sinus bradycardia.
Materials & Methods
Table 2. Comparison between patients admitted to ICU or with new EKG changes
vs patients admitted to a regular cardiac monitor stepdown unit
This is a retrospective study. The Electronic Medical Records from patients who reported using SC the Emergency Department (ED) of Metropolitan Hospital Center for the year 2014 were reviewed. Patients with cardiovascular manifestations were separated into two groups; one group admitted to the Intensive Care Unit or with new EKG changes and the other group of patients with chest pain, sinus bradycardia or tachycardia, hypo or hypertension, and syncope who were admitted to a cardiac monitored stepdown unit.
Conclusions
In our study the main cardiovascular manifestation associated with use of SC was sinus bradycardia. Those patients who required intensive care or with new EKG changes had a longer hospital stay..
References
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