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Incidence of cardiovascular symptoms and adverse events following self-reported acute cannabis intoxication at the emergency department: a retrospective study
  1. Femke Gresnigt1,2,
  2. Lianne C van den Brink1,
  3. Claudine Hunault2,
  4. Eric Franssen3,
  5. Dylan de Lange2,
  6. Robert Riezebos4
  1. 1 Emergency Department, OLVG, Amsterdam, The Netherlands
  2. 2 Dutch Poisons Information Center (DPIC), UMC Utrecht, Utrecht, The Netherlands
  3. 3 Hospital Pharmacy, OLVG, Amsterdam, The Netherlands
  4. 4 Cardiology Department, OLVG, Amsterdam, The Netherlands
  1. Correspondence to Dr Femke Gresnigt, Emergency department, OLVG, Amsterdam, Noord-Holland, Netherlands; F.M.J.Gresnigt{at}

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Cannabis is one of the most popular illicit drugs and usually considered harmless.1 However, emergency department (ED) cannabis-related admissions are increasing, and serious cardiovascular complications have been reported.2 It is unclear whether all these patients should receive a thorough cardiovascular evaluation in the ED. This study aimed to determine the frequency and severity of cardiovascular symptoms and complications in a cannabis-intoxicated ED population.

This retrospective study used a convenience sample of all self-reported cannabis-intoxicated adult patients who presented at an Amsterdam inner-city ED between 1 January 2016 and 31 December 2019. Patients were identified from the electronic patient record by one investigator, through the general toxicology registration, including all intoxication-related ED presentations via triage complaints, diagnosis and/or International Classification of Diseases, 10th Revision (initiated on 1 January 2016). Data were abstracted using a standardised data collection sheet (online supplemental file). History taking was non-standardised and patients with mixed recreational drug intoxication (excluding alcohol) or without symptoms regarding cannabis use were excluded. Symptoms were categorised as either cardiovascular (palpitations, chest pain and syncope) or non-cardiovascular (like nausea and vomiting). The frequency and type of cardiovascular symptoms …

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  • Handling editor Gene Yong-Kwang Ong

  • LCvdB and CH contributed equally.

  • Contributors FG, LCvdB and RR conceived the study and designed the trial. FG, EF, DdL and RR supervised the trial. LCvdB performed the data collection and analysis. CH performed the statistical analyses. FG and LB drafted the manuscript. All authors contributed substantially to its revision. FG was responsible for the paper as a whole.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.