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While the legalization of marijuana invades North America, the consumption of this substance has increased and the public's attitude is changing. A growing number of people believe that the "weed" is the safest recreational drug, one that has health benefits that outweigh the risks. These badumptions are disputed in an article and an editorial published in the Canadian Journal of Cardiology who examine the story of a patient who developed overwhelming chest pain and myocardial ischemia after consuming most of a pacifier with marijuana.
"Marijuana can be a helpful tool for many patients, especially for pain and nausea, and, like all other medications, has risks and side effects. Oral Consumption of Marijuana by an Elderly patient with stable cardiovascular disease caused distress that caused a cardiac event and a reduction in cardiac function, "said Alexandra Saunders, MD, Dalhousie University, Department of Internal Medicine and Departmental Program Horizon Health Network Cardiology Center, Saint John, NB, Canada.
The case report describes a 70-year-old man with stable coronary artery disease, taking the appropriate heart medications, who consumed most of a lollipop infused with 90 mg of THC (delta-9-tetrahydrocannabinol) to relieve the pain and help with sleep, which has resulted in a potentially serious heart attack. He consumed a much higher dose than the usual 7 mg taken by smoking a single joint or taking the initial dose of 2.5 mg of Dronabinol (Marinol), a synthetic THC marketed for the stimulation of nausea and vomiting. Appetite in patients with AIDS and cancer. Although the patient smoked marijuana in his youth, he had not done so since the THC content of the substance had increased significantly from 3% to 12%. He also did not know the prolonged and delayed effect of oral administration of THC.
The patient's cardiac event was probably due to an unexpected tension on his body, caused by fearful anxiety and hallucinations, caused by the unusually large amount of THC ingested. Its sympathetic nervous system was stimulated, resulting in an increase in cardiac output with tachycardia, hypertension and release of catecholamine (stress hormone). After the disappearance of the psychotropic effects of the drug and the end of his hallucinations, his chest pain stopped.
A number of previous case reports, as well as epidemiological studies, have described the link between cannabis use and acute cardiovascular adverse events, including myocardial infarction, stroke. , arrhythmias and sudden death.
"Most of the previous research on marijuana-induced myocardial ischemia focused primarily on the youngest patients and not on its different formulations and potential.As a result of the widespread legalization of marijuana, must understand and manage cannabis use and its complications in patients especially in people with cardiovascular disease, "said Robert S. Stevenson, MD, Horizon Health Network, Department of Cardiology, Saint John, NB, Canada .
The CV toxicity of marijuana is described in an accompanying editorial. This can be considered as a consequence of one or more of the following: 1) inhalation of marijuana products; 2) direct CV effects of THC; and 3) the indirect effects of THC related to acute anxiety, hallucinations and / or psychosis. People who are naive to THC and who are not used to taking psychotropic drugs can become very distressed by impaired cognition and feelings of loss of control from THC. Extreme emotional reactions in the context of the psychiatric toxicity of THC are badociated with catecholamine surges, which can lead to acute adverse CV effects. Important considerations regarding the toxicity of cannabis are the mode of use, the dose, the route of administration and the degree of tolerance.
"The legalization of cannabis is generating considerable public support, but also raises public health issues," commented author of the editorial, Neal L. Benowitz, MD, head of the Division of Clinical Pharmacology and Experimental Therapeutics, Medical Service, Departments of Medicine and Biopharmaceutical Sciences. Center for Research and Education in Tobacco Control, University of California, San Francisco, California, USA. "Some users may benefit from social and medical effects, but others may have adverse health effects.No information was disseminated to patients or health care providers on the Internet. cannabis use in older patients, especially those with cardiovascular disease, or worse, providing advice and care to these patients who use cannabis is now necessary to provide optimal medical care to these patients. "
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Material provided by Elsevier. Note: Content can be changed for style and length.
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