Kratom, derived from the leaves of the Mitragyna speciosa tree native to Southeast Asia, has gained attention for its stimulant and pain-relieving properties. People commonly consume it in various forms, such as brewed tea or powder, for a range of perceived benefits. However, scientific inquiry and anecdotal reports raise questions about its potential impact on cardiovascular health. This article explores the current understanding of kratom’s effects on the heart.
Evidence of Cardiac Effects
Scientific literature, including case reports and reviews of poison center data, suggests a link between kratom use and cardiovascular issues. For example, analyses of national poison data have identified tachycardia, an abnormally fast heart rate, and hypertension, or high blood pressure, as commonly reported adverse cardiovascular effects associated with kratom consumption. These reports highlight a correlation, but often involve situations where kratom was used alongside other substances, complicating a definitive conclusion solely attributing effects to kratom.
Coroner and autopsy reports have also indicated various cardiovascular findings in individuals who used kratom, including coronary atherosclerosis, myocardial infarction (heart attack), and left ventricular hypertrophy (enlargement of the heart’s main pumping chamber). A direct causal link between kratom use alone and these severe conditions requires further investigation, as underlying medical conditions or polysubstance use often contribute to observed outcomes.
Specific Heart-Related Concerns
Kratom use has been associated with several specific heart-related concerns. One frequently reported issue is tachycardia, which involves an elevated heart rate, often exceeding 100 beats per minute at rest. This rapid heartbeat can be particularly problematic for individuals with pre-existing heart conditions.
Another concern is hypertension, or high blood pressure, where blood pressure readings consistently stay above normal levels. While smaller doses might lead to a slight increase, higher doses of kratom could result in more pronounced elevations in blood pressure. Additionally, irregular heartbeats, known as arrhythmias, including ventricular arrhythmia, have been reported in some cases associated with kratom use.
There are also reports of QT prolongation, a disorder of the heart’s electrical system that can increase the risk of serious arrhythmias like torsades de pointes. Although some in vitro studies suggest mitragynine, a primary alkaloid in kratom, can prolong the QTc interval, clinical studies examining regular human consumption have not consistently reported this risk, though some noted a dose-dependent increase in the QTc interval. In rare instances, more severe conditions such as cardiomyopathy, a disease of the heart muscle that makes it harder for the heart to pump blood, and cardiomegaly, or an enlarged heart, have been noted in autopsy reports.
How Kratom Might Affect the Heart
The potential ways kratom’s compounds might influence cardiovascular function are complex and involve several biological pathways. Mitragynine, the most abundant alkaloid in kratom, and other active compounds can interact with various receptors in the body, including opioid, alpha-2 adrenergic, and 5-HT2A receptors. These interactions can lead to a combination of stimulant and analgesic effects, which may directly impact the heart.
One mechanism involves the adrenergic system, which plays a significant role in regulating heart rate and blood pressure. Kratom alkaloids may influence this system, contributing to observed effects like increased heart rate and blood pressure. Furthermore, in vitro studies indicate that kratom can inhibit myocardial potassium channels in a concentration-dependent manner. This inhibition can prolong the action potential duration in heart cells, potentially increasing the risk for QT prolongation and certain types of arrhythmias.
Beyond direct receptor interactions, kratom might affect electrolyte balance within the body, such as potassium and magnesium levels, which are crucial for proper heart function. For example, a case report noted low potassium levels in a patient who developed heart abnormalities after kratom ingestion. Interactions with other medications are also a consideration, as kratom could potentially alter the metabolism of other drugs or exacerbate their side effects, particularly those that also affect cardiac rhythm.
Recognizing Signs and When to Seek Care
Being aware of certain symptoms after kratom use can help individuals recognize potential heart problems. These include:
Chest discomfort or pain, from a mild pressing sensation to intense pain.
Shortness of breath, especially with minimal exertion.
Palpitations, such as a racing, pounding, or fluttering heart, or skipped beats.
Dizziness or lightheadedness, which may suggest reduced blood flow to the brain.
Fainting or near-fainting episodes, which require immediate medical evaluation.
If any of these symptoms occur after using kratom, it is important to seek immediate medical attention. Prompt consultation with a healthcare professional can help determine the underlying cause and ensure appropriate care.