Selman Yeniocak1, Asım Kalkan2, Adnan Yamanoğlu3*, Semi Öztürk4, Özgür Söğüt1, Merve Metiner5

1Department of Emergency Medicine, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
2Department of Emergency Medicine, Okmeydanı Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
3Department of Emergency Medicine, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey
4Department of Cardiology, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
5Department of Emergency Medicine, Gaziosmanpaşa Training and Research Hospital, Istanbul, Turkey

Keywords: Bonsai, cannabinoids, cannabis, electrocardiogram, K2, marijuana, spice


OBJECTIVES: Limited clinical studies have investigated the effects of synthetic cannabinoids (SCs) on the cardiovascular system (CVS). The aim of this study was to evaluate the effects of SCs on the CVS.

METHODS: The patient group of this single-center, prospective, case–control study consisted of adult patients presenting to the emergency department (ED) with symptoms of SC use. Vital signs and electrocardiogram (ECG) after use of SC of patients were followed. A control group with a similar number of patients and patient demographics were formed following the patient admission process. Pulse rate, arterial blood pressure (ABP), and ECG of patient and control groups were compared using Mann–Whitney U and Chi-squared tests.

RESULTS: A total of 148 people were included in the study, 74 in the patient group and 74 in the control group. Systolic and diastolic ABPs of patient group were statistically significantly lower than those of the control group (P < 0.001). P-wave width and amplitude in the patient group were significantly higher compared to the control group (P: 0.027 and P: 0.004, respectively). QRS width on patient group ECGs was significantly higher than in the control group, while T-wave amplitude was significantly lower (P: 0.045 and P < 0.001, respectively). ST elevation was seen in 12 (16.2%) subjects in the patient group, while no ST elevation was seen in the control group (P < 0.001).

CONCLUSION: SCs can reduce systemic tension and SCs may cause changes in ECG, especially P wave, ST segment, T wave, and QRS. Further large-scale studies are needed to show whether these changes are associated with fatal arrhythmias or myocardial infarction.

Ethics Committee Approval

Ethical consent was obtained for this study from the local ethics committee of Haseki Training and Research Hospital with the number 2017/422, on date of 17.06.2017.

Author Contributions

Conception and design: Adnan Yamanoglu, Selman Yeniocak, Semi Ozturk, Asım Kalkan, Merve Metiner, Ozgur Sogut; acquisition of data or analysis and interpretation of data: Selman Yeniocak, Merve Metiner, Adnan Yamanoglu, Semi Ozturk; drafting the article or revising it critically for important intellectual content: Selman Yeniocak, Adnan Yamanoglu, Semi Ozturk, Asım Kalkan, Ozgur Sogut; final approval of the version to be published: Asım Kalkan, Ozgur Sogut, Adnan Yamanoglu, Semi Ozturk; for all aspects of the work in ensuring that questions related to the accuracy and integrity appropriately investigated and resolved: Adnan Yamanoglu, Selman Yeniocak, Semi Ozturk, Asım Kalkan, Ozgur Sogut, Merve Mertiner.

Conflict of Interest

None Declared.

Financial Disclosure



The authors verify and confirm that everyone who contributed to this manuscript is either listed as an author or acknowledged as a contributor in the acknowledgement section, and that the title page details any professional writing assistance or others paid to provide manuscript support.