Study finds love of cannabis can lead to ‘broken heart’

Non-medical cannabis has been legal in Canada since 2018. Although a primary motivation for legalization was to enhance public awareness of the health risks associated with cannabis use, the Canadian government’s online resources regarding cannabis harms may not reveal the full picture.

Well-known health impacts of cannabis use include respiratory issues, decreased cognitive ability, psychosis and risk of future substance use.

Recently, cannabis dependence has been identified as a risk for users of all ages. Approximately one in 10 adults and one in six adolescents who experiment with cannabis will become dependent. The risk increases to one in two for daily users.

Chronic use refers to weekly or more frequent cannabis use over a period of months or years. Chronic cannabis users are at risk of more severe and less frequently discussed health consequences. One example is Takotsubo cardiomyopathy (TTC).

This conditions is rarely mentioned in the media, and is also absent from Canada’s online consumer resources on cannabis, despite its potential to be debilitating and, in some cases, fatal.

Takotsubo cardiomyopathy, also known as “broken heart syndrome,” is an acute reversible heart failure condition characterized by the weakening of the heart’s left ventricle, often caused by severe emotional or physical stress. “Takotsubo” refers to the apical ballooning shape in TTC, which resembles Japanese octopus traps.

Although originally believed to be a benign condition, there is a substantial risk of mortality with TTC.

TTC is most common in post-menopausal women, however, studies have suggested a link between chronic cannabis use and TTC in younger individuals. Incidents of TTC in cannabis users are associated with serious illness including stroke and cardiac arrest, even though these patients usually have more favourable cardiac risk factor profiles compared to older, non-cannabis using patients.

While the interplay between chronic cannabis use and TTC remains unclear, researchers have hypothesized cannabis use and stress have similar hyper-activation effects on the amygdala, a structure located in the brain’s temporal lobe.

Excessive activation of the amygdala and the sympathetic nervous system is believed to be a dominant contributor to TTC.

Although I research cannabis, I was unaware of TTC until I heard Liv Wilder’s podcast. I reached out to Wilder, who lives in the United States, to ask about his experience with cannabis and these conditions, which he also discusses on Instagram.

When Wilder was introduced to cannabis at age 20, he found a new sense of peace after struggling with anxiety and alienation since childhood. He began using cannabis daily.

After several months, he began experiencing intense nausea and vomiting that would last for hours. Some episodes required emergency room visits, where he received intravenous anti-nausea medication, but no clear diagnosis.

When Wilder switched from dried flower to concentrates, colloquially known as “dabs,” the higher dose of cannabinoids increased the frequency of his nausea and vomiting. Over the next two years of cannabis use, his nausea and vomiting became increasingly tortuous.

After a minor, unrelated surgical procedure performed under general anesthesia, Wilder breathed vomit into his lungs during recovery, turned blue and was rushed to emergency.

The apex of his heart had ballooned due to the stress of the anesthesia, years of chronic cannabis use and persistent vomiting. He was put on dialysis and life support, which led to a blockage in his right femoral artery, resulting in his foot becoming necrotic. His leg was amputated while he remained in a coma.

He woke up some time after surgery as an above-the-knee amputee. Three years of chronic cannabis use had cost him his leg.

Wilder was diagnosed with TTC, acute kidney injury and neuropathy in his left foot. He struggled with cannabis and alcohol abuse for 18 months following his amputation, but has abstained from both since July 2019. He is now very active in the gym, and loves rock climbing and camping.

Kristen Yeh is a Ph.D candidate in environmental chemistry at the University of Toronto.