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Comment by j4yav | Hacker News Reader

What does it mean to visit an ER for cannnabis? Wouldn’t that typically be an anxiety attack in the first place?

If you've never had a panic attack before, the first one is easy to mistake for something a lot more dangerous.

During a mental health first aid course, I remember being told those mistakes can (admittedly rarely) happen in the other direction too. ie someone thinking they were having a panic attack actually having a heart attack instead.

The advice was to go call an ambulance anyway for someone having a serious panic attack. But for what it's worth, that advice was given somewhere where calling ambulances won't cost you.

A friend of my father unfortunately had a similar issue. Complained of acidity in the morning, dead from a heart attack by afternoon. It's much better to be over-cautious in such cases.

The key word here is father. If you're in your 20s or 30s, chances of it being heart attack instead of panic attack are incredibly low.

While I mostly agree, I myself unfortunately very likely experienced pericarditis after my covid shot. Worst pain I've had in a long time, but I was "sure" it was just gas and "couldn't be a heart issue because it's been going on for x hours or else I'd have been dead". I wish diagnostics was easier for health & heart conditions.

Indeed, while not cannabis related, I visited the ER once due to a panic attack (which I did't know at the time). My combination of high heart rate, mild abdominal pain, and a low grade fever triggered their sepsis protocol. This constellation of symptoms caused me to spiral more and eventually I was discharged with nothing more than some chill pills and constipation.

I experienced this personally about 3 years. I had a panic attack so bad I didn't understand what was happening. Cue 3AM ambulance ride to the ER and all that. What was crazy was that when they did the tests in the ER, the main biomarker they look for a heart attack was mildly elevated. Higher than you'd like. But - barely - in the diagnostic range. Three days later, after a battery starting at ECG, and continuing through a full stress test and heart cath I was given a clean bill of health and sent home.

Elevated troponin? If so I had a very similar experience.

I had a random episode of afib about 10 years ago and my EKG has been known to make doctors nervous (I've been told that its strange but apparently its "normal" for me). After the afib episode, I became very paranoid about my heart rhythm and I think the paranoia exacerbated a previously latent anxiety issue. One day the paranoia became so bad that I thought I was having another afib episode but I wasn't 100% sure. I was self aware enough to know that I was mild hypochondriac and that it was likely that nothing was wrong. It was a Sunday so I went an urgent care. I figured they would check my heart, tell me everything was fine and it would put my mind at ease. They gave me and EKG and when urgent care doc saw it, he told me to go to the hospital immediately.

Long story short. The ER doctor thought everything was fine and was going to release me until my troponin levels came back elevated. I was put in ICU, given an ECG, and hearth cath. They didn't fine anything and released me. My anxiety became a lot worse after that. A few days later I went back to the ER. They checked my troponin levels and they elevated again (they dropped over the course of the first hospital stay) so I was admitted again. This time I did a full heart MRI. They didn't find anything. No signs of heart attack or heart damage (which high troponin is supposed to be an indicator of).

My anxiety was almost debilitating after that. Took me years to recover.

That sounds familiar?

I even had a little scare about a decade ago when a little transient tachycardia showed up during a sleep study.

Yeah, anxiety has not returned to baseline. COVID has certainly not helped. I haven’t caught it - but I am medically… complicated and a lot of my stuff is respiratory. I mask when I can, which helps but one can only do so much. At least I have a sympathetic GP so I have Ativan for when things are bad now.

It’s a hell of a feedback loop. When I’m super anxious - surprise surprise - my HR and BP are way up (and if I’ve had to use my asthma meds… oh lawd.) thus they want to keep you because you’re not “normal”. Want that stuff to come down? Gimme something nice to relax me, and let me sleep for 5 or 6 hours without a bunch of leads on or someone waking me up every minutes to stick a thermometer under my tongue.

Cannabinoid hyperemesis syndrome? Asthma attack? Being way too high?

Just some guesses.

Some consequences of illegal substances are things like "lack of standard dosage" and "lack of consumer education."

Someone who has never taken cannabis before, accidentally not realizing they've consumed too much, not knowing how to handle it, and wondering if they're okay, and calling 911 or going to the ER, is not an unfamiliar story.

The only I've heard about:

- psychosis

- green out/being absolutely ripped, and found by others, who in turn will take you to the ER.

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