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

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.

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.

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.

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.

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.