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Study breakdown

Cannabis Use Triggered Life-Threatening Heart Condition Requiring Intensive Cardiac Support

Case ReportPreliminary evidence
The takeaway

A 63-year-old woman developed Takotsubo cardiomyopathy with cardiogenic shock and ventricular tachycardia after cannabis use, requiring a heart pump and weeks of intensive care to recover.

Cardiologists, emergency physicians, critical care teams

What the researchers found

A 63-year-old woman with prior cannabinoid hyperemesis syndrome admissions presented with nausea, vomiting, and cardiopulmonary distress after cannabis use. She developed ventricular tachycardia requiring cardioversion, cardiogenic shock, and a left ventricular ejection fraction of 15-20% (normal is 55-70%). Cardiac catheterization showed no coronary artery disease, consistent with Takotsubo (stress) cardiomyopathy. She required an intra-aortic balloon pump and milrinone infusion, with cardiac function returning to baseline after 4 weeks of intensive management.

Why it matters

While cannabis-related cardiovascular events are increasingly recognized, Takotsubo cardiomyopathy with cardiogenic shock represents a severe, potentially fatal cardiac complication. This case links repeated cannabinoid hyperemesis syndrome to a life-threatening cardiac event.

The numbers in context

Age 63; troponin 22,900 ng/L; NT-proBNP 21,092 pg/mL; LVEF 15-20%; lactic acid 7.1; potassium 2.6; positive for THC; no coronary lesions; LVEF recovered to baseline after 4 weeks

How the study worked

Single case report documenting the clinical course, diagnostic workup, and treatment of cannabis-associated Takotsubo cardiomyopathy with cardiogenic shock in a 63-year-old woman.

What this study cannot tell us

Single case report cannot establish causation. Patient had CHS history and severe metabolic derangements (hypokalemia, lactic acidosis) that independently could contribute to cardiac dysfunction. Temporal association with cannabis use does not prove causality.

How to read the evidence

Preliminary: single case report with temporal association but cannot establish causation.

When this study was published

2025 publication

The bigger picture

Takotsubo cardiomyopathy is triggered by catecholamine surges during extreme stress. Cannabis may precipitate this through its cardiovascular effects (tachycardia, blood pressure changes) or indirectly through the physiological stress of hyperemesis syndrome with severe dehydration and electrolyte derangement.

Questions still open

  • Is the cardiac risk from cannabis itself or from the metabolic consequences of hyperemesis?
  • Should patients with CHS history be screened for cardiac complications?

Read the original research

Cannabis-Related Takotsubo Cardiomyopathy Presenting With Ventricular Tachycardia and Cardiogenic Shock Successfully Treated With Milrinone and Intra-Aortic Balloon Pump.

JACC. Case reports, 30(20), 104246

Citation

Haque, Obaid I; Kiyani, Madiha; Hussain, Shahzad. (2025). Cannabis-Related Takotsubo Cardiomyopathy Presenting With Ventricular Tachycardia and Cardiogenic Shock Successfully Treated With Milrinone and Intra-Aortic Balloon Pump.. JACC. Case reports, 30(20), 104246. https://doi.org/10.1016/j.jaccas.2025.104246

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