Shah Vivek D, Mohammad Adeba, Nandkeolyar Shuktika, Stoletniy Liset, Contractor Tahmeed
Department of Internal Medicine, Loma Linda University Medical Center, CA, USA.
Department of Internal Medicine, Division of Cardiology, Loma Linda University Medical Center, CA, USA.
Case Rep Cardiol. 2021 Jul 8;2021:6621496. doi: 10.1155/2021/6621496. eCollection 2021.
There are several recent reports of tetrahydrocannabinol vaping-related sudden cardiac arrest, and the mechanisms are unclear. We report a unique case of a 19-year-old female who suffered documented prolonged QTc leading to Torsades de pointes and cardiac arrest in the setting of frequent marijuana wax vaping. While she demonstrated normal baseline QTc measurements years earlier, she was found to have a genetic predisposition to QTc prolongation (genetic mutation, family history of prolonged QTc), suggesting that specific patient populations are at higher risk of these adverse events. The patient was acutely managed with isoproterenol to increase the heart rate and was discharged on nadolol after placement of an implantable cardioverter-defibrillator. Marijuana wax vaping and dabbing may cause fatal Torsades de pointes in susceptible patients, and further research is required to identify these patients a priori.
近期有几篇关于与四氢大麻酚雾化相关的心源性猝死的报道，其机制尚不清楚。我们报告了一例独特的病例，一名19岁女性，在频繁吸食大麻蜡的情况下，出现记录在案的QTc间期延长，导致尖端扭转型室速和心脏骤停。虽然她几年前的基线QTc测量值正常，但发现她有QTc延长的遗传易感性（基因突变、QTc延长家族史），这表明特定患者群体发生这些不良事件的风险更高。该患者接受了异丙肾上腺素急性治疗以提高心率，并在植入植入式心脏复律除颤器后服用纳多洛尔出院。吸食大麻蜡和涂抹大麻可能会在易感患者中导致致命的尖端扭转型室速，需要进一步研究以便事先识别出这些患者。
