Variation in heart rate after acute cannabis exposure

Figures & data

Table 1. Heart rate in patients with cannabis toxicity from various exposures and sources.

Exposure	Source	N (N = 101)	Bradycardia, n (%)	Tachycardia, n (%)	Normal HR, n(%)	Mean HR, bpm	Median HR, bpm (IQR)	HR range
Ingestion	Botanical	4	1 (25)	2 (50)	1 (25)	120	130	87-140
	All Botanicals	4	1 (25)	2 (50)	1 (25)	120	130	87-140
	Commercial Edible	21	1 (5)	13 (62)	7 (33)	107	118	56-160
	Homemade Edible	24	1 (4)	15 (63)	8 (33)	109	107	55-173
	Edible-unknown source	14	0 (0)	9 (64)	5 (36)	112	108	78-170
	All Edibles	59	2 (3)	37 (63) #	20 (34)	109	110 (98-130)	56-173
	Resin	3	2 (67)	1 (33)	0 (0)	90	50	50-170
	Concentrate	12	0 (0)	5 (42)	7 (58)	114	112	70-185
	All Resins & Concentrates	15	2 (13)	6 (40) #@	7 (47)	104	110 (79-132)	50-185
	Total ingestion	76	5 (7)	45 (59) ^	26 (34)	108	110 (97-130)	50-185
Inhalation	Botanical	15	1 (7)	12 (80)	2 (13)	116	126	50-173
	Resin	7	0 (0)	6 (86)	1 (14)	120	119	98-160
	Concentrate	3	0 (0)	3 (100)	0 (0)	130	130	122-140
	All resin & Concentrate	10	0 (0)	9 (90) @	1 (10)	123	123 (112-138)	98-160
	Total inhalation	25	1 (4)	21 (84) ^	3 (12)	119	125 (110-138)	50-173
		n (N = 101)	Bradycardia, n (%)	Tachycardia, n (%)	Normal HR, n (%)
Age	< 12 years	25	2 (8)	12 (48)+	11 (44)
	12-18 years	26	2 (8)	20 (77)+	4 (15)
	>18 years	50	2 (4)	33 (66)	15 (30)

^ compared to the other ^; p < 0,05.

# compared to the other #; p < 0.05.

@ compared to the other @; p < 0.05.

+ compared to the other +; p < 0.05.

Table 2. Predominant clinical signs and symptoms according to heart rate.

	CNS excitation, n (%)	Sedation, n (%)	Other symptoms, n (%)
Tachycardia n = 65	35 (54%)	8 (12%)	22 (34%) 5 gastrointestinal 5 palpitations 5 altered mental status 5 lightheaded 2 asymptomatic
Normal Heart Rate n = 30	10 (33%)	13 (43%)	7 (23%) 0 gastrointestinal 2 palpitations 2 altered mental status 1 lightheaded 2 asymptomatic
Bradycardia n = 6	1 (17%)	4 (67%)	1 (17%) 1 lightheaded

CNS = Central Nervous System.

Table 3. Clinical characteristics of patients who developed bradycardia.

Age	Type	Exposure	HR (bpm)	BP (mmHg)	Symptoms	Disposition	Notes
2yo M	Botanical	Ingestion	87	125/53	Somnolent	ED, then discharged	Family member’s botanical cannabis
70yo M	Botanical	Inhalation	50	150 syst	Dizzy, lightheaded, vertigo	ED, then discharged	First time use; cannabis naïve
87yo F	6-8 commercial brownies (unknown dose)	Ingestion	56	99/51	Somnolent, altered mental status. In ED, developed atrial fibrillation with rapid ventricular rate.	Admit ward
16yo M	Homemade brownie	Ingestion	55	87/33	Paranoia, agitation, nausea	ED, then discharged
15yo M	Resin	Ingestion	50	102/80	Somnolence, syncope, vomiting	ED, then discharged	Dab given by friend
13mo M	Resin	Ingestion	50	105/49	Obtundation, seizure	Admit ward	Parent’s dab

HR = heart rate.

BP = blood pressure.

yo = year old.

mo = month old.

M = male.

F = female.

bpm = beats per minute.

ED = emergency department.