SHM Converge Scientific Abstract ePoster Gallery-Kratom: A Pain Killer That Can Kill!

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This case report describes a 46-year-old man with chronic knee pain who developed sudden ventricular fibrillation after using kratom for pain relief. He initially presented with nausea, vomiting, and epigastric pain, then became unresponsive and required CPR, cardioversion, intubation, amiodarone, and ICU care with hypothermia protocol. Workup showed normal electrolytes and troponins, mild transaminitis, and a prolonged QT interval (500–530 ms). Echocardiography and cardiac catheterization ruled out ischemic disease; an anomalous left circumflex artery was found but later considered non-malignant. Standard toxicology testing was negative.<br /><br />The patient had no personal or family history of heart disease and no known caffeine use, but later disclosed kratom use to treat chronic pain. Kratom, derived from Mitragyna speciosa, is commonly used in the U.S. for its stimulant and analgesic effects. Its main alkaloids, mitragynine and 7-hydroxymitragynine, act on opioid receptors. Previous reports have linked kratom to QT prolongation and arrhythmias, likely through potassium channel inhibition, but ventricular fibrillation is rare and novel.<br /><br />The report emphasizes that kratom may cause serious and potentially fatal cardiac arrhythmias, that it is not detected on routine toxicology screens, and that clinicians should ask specifically about its use in patients with unexplained arrhythmias. More research is needed to clarify kratom’s cardiotoxic mechanisms and risk.

Asset Subtitle

Varsha Konyala

Meta Tag

Author List Danny Aiti, FNU Sahil, Jennifer Bolyard, Mowen Wang, Varsha Konyala

Category Clinical Vignettes

Concept Kratom

Concept Cardiotoxicity

Concept Antipsychotic-Induced QT Prolongation

Concept Ventricular Arrhythmia

Concept Ventricular Fibrillation

Distinguished Non-Finalist

Presenter Organization Canton Medical Education Foundation/ NEOMED

Presenting Author Varsha Konyala

Track Adult

Keywords

kratom

ventricular fibrillation

QT prolongation

arrhythmia

cardiotoxicity

Mitragyna speciosa

mitragynine

7-hydroxymitragynine

chronic pain

toxicology screen

Kratom

Cardiotoxicity

Antipsychotic-Induced QT Prolongation

Ventricular Arrhythmia

Ventricular Fibrillation