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Cardiotoxicity of new psychoactive substances – A review of experimental studies and real clinical and forensic cases
1
Department of Forensic Medicine and Toxicology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
2
Department of Histopathology, Silesian Centre for Heart Diseases in Zabrze, Poland
3
Doctoral School, Medical University of Silesia, Katowice, Poland
4
Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Silesian Centre for Heart Diseases in Zabrze, Poland
These authors had equal contribution to this work
Corresponding author
Rafał Skowronek
Katedra i Zakład Medycyny Sądowej i Toksykologii Sądowo-Lekarskiej, ul. Medyków 18, 40-752 Katowice
Katedra i Zakład Medycyny Sądowej i Toksykologii Sądowo-Lekarskiej, ul. Medyków 18, 40-752 Katowice
Ann. Acad. Med. Siles. 2026;80:184-189
KEYWORDS
designer drugintoxicationcathinonescannabinoidscardiac arresttachycardiacardiomyopathyclinical pharmacology
TOPICS
ABSTRACT
Designer drugs pose a serious modern health threat, specially the two most popular groups: synthetic cannabinoids and synthetic cathinones. Most of the available literature focuses on the neurological effects and scarcely describes effects on the cardiovascular system, which is responsible for most of the fatal cases. This article reviews the current knowledge about the cardiovascular effects of this new type of drugs. By activating CB1 receptors, cannabinoids cause no effect or may cause myocardial infarction because of vasoconstriction and a chronotropic effect. The arrhythmogenic effect includes tachycardia, atrial fibrillation, and even asystole. Synthetic cathinones contract blood vessels and increase contractility and stroke volume, leading to myocardial infarction through mechanisms unrelated to the autonomic system and independent of indirect sympathomimetic mechanisms. Describing typical symptoms and changes in electrocardiogram after overdosing such substances is crucially important, because unlike other drugs, laboratories cannot keep up with their ever-changing composition. There is a growing need for a proper identification protocol to identify their symptoms.
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