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Three teenagers were treated within weeks of each other at a hospital emergency department for myocardial infarction caused by use of the synthetic cannabinoid known as ‘K2′ or ‘Spice.’ The occurrence of these teenage patients’ heart attacks and drug use have been documented in a new study by their doctors from the Children’s Medical Center in Dallas and published in the December issue of Pediatrics.

Side effects caused by use of synthetic cannabinoids like K2 have remained relatively unknown in the realm of scientific research. Yet doctors and clinicians around the nation have encountered serious symptoms or illness among hospital admissions-the majority of which are adolescents and young adults. Now, the new study on the substances has found a direct link between teenager’s use of K2 and heart attacks; because heart attacks are highly rare but deadly among adolescents, the study’s authors are cautioning other clinicians to consider the use of these synthetic drugs by their teenage patients with symptoms of chest pain and myocardial ischemia.

K2 and related brands are herbs laced with the synthetic cannabinoids, and are currently available on the Internet and in various specialty stores marketed as ‘incense’ to mask their true intended form of use. Despite their accessibility, these synthetic cannabinoids can cause serious adverse effects in users since their ingredients and manufacturers are typically of unknown origins. Earlier this year, the U.S. Department of Drug Enforcement Agency enforced an emergency ban on five types of synthetic cannabinoids known to cause harm to users, yet hundreds of these manufactured cannabinoids remain in the market and undetectable in standard drug testing. Because the majority of the synthetic drugs are not officially considered illicit substances under law, underage teens continue to be able to purchase and use K2 unrestrictedly. In addition, the synthetic cannabinoid-designed to mimic the effects of THC, the main ingredient found in natural cannabis- has actually been found to cause much more intense physical and mental effects than cannabis such as heightened anxiety, high blood pressure, hallucinations, psychotic episodes, and seizures even days after use. For pediatric cardiologist Dr. Colin Kane at the Children’s Medical Center in Dallas, three specific cases of teenage myocardial infarction caused enough alarm for he and his colleagues to investigate these drugs’ risks to the public.

Within weeks, three different 16-year-old teenage males were presented to Dr. Kane’s emergency department with symptoms of chest pain. Because of the rarity of heart attacks among teenagers, doctors usually suspect a virus is involved in such cases of chest pain. However, the patients’ electrocardiograms detected elevated levels of troponin-the protein which in high amounts is associated with heart attacks. After coronary angiography was performed, two of the patients were found to have suffered heart attacks, while the third patient subsequently suffered one after being hospitalized. All three patients were found to have histories of good health, but to have smoked K2 just days prior to their admissions. The teenagers also tested negative for other illicit substances such as cocaine and methamphetamine.

Although all three patients had ingested a synthetic cannabinoid, the doctors note that the type and amount of cannabinoid used would be practically impossible to trace since hundreds of variations and manufacturers exist, like Yucatan Fire, Solar Flare, Genie, Fire n’ Ice, Spice, PEP Spice, and Spice Diamond. Additionally, it could be possible that the synthetic cannabinoids the boys used may have been contaminated. However, the study’s authors do believe that the drugs may have led to increased blood flow to the coronary arteries, therefore cutting off the body’s blood supply and causing the heart to spasm.

John Huffman, the chemist who originally developed synthetic marijuana after conducting research on cannabinoids for the U.S. National Institute on Drug Abuse, has cited the substances as being toxic and not intended for human consumption due to their heightened potency. Having grown into a major market worldwide since 2009, the popular synthetic cannabinoids have caused 16 states to ban the drugs due to increasing numbers of poisonings and hospitalizations among minors.

The researchers suggest their findings to be further investigated by other scientists to help further determine the risks of synthetic cannabinoids. For now, they hope their findings will help promote more public awareness of K2′s health implications so parents and children understand the potential dangers that even healthy teens face from these types of drugs.