Cannabinoids: A Cause of Severe Bradycardia

The use of recreational cannabis affects almost all countries in the world, being illegal in most of them. Cannabis formulations include several compounds, with cannabidiol (CBD) being one of the best studied. One of its effects is its action in adenosine (anti-arrhythmic) receptors. We present the case of a 39-year-old male with chronic anxiety and regular inhaled cannabis consumption who reported to the emergency department (ED) after a first use of inhaled CBD. While in the ED, the patient presented with four episodes of syncope. EKG was performed and an extreme bradycardia with a sinus pause of 13.8 seconds was observed. Marijuana consumption is associated with various clinical manifestations, such as bradycardia, sinus pauses, and orthostatic hypotension. The tropism of this toxic for adenosine receptors can induce severe bradycardia, which can be life-threatening.