Cocaine-Induced Isolated Bradycardic Atrial Flutter: A Rare Presentation in a Patient With a History of Acute Coronary Syndrome

Six months ago, a middle-aged African American male visited the cardiology clinic for a follow-up on acute coronary syndrome along with atrial fibrillation. The patient was initially diagnosed with unstable angina with palpitation and underwent cardiac catheterization. During the visit, the patient complained of unspecific chest discomfort, palpitation, and reduced exercise tolerance after the use of cocaine for several months. ECG showed the absence of atrial fibrillation but instead showed atrial flutter with bradycardia. Cocaine-induced atrial flutter was suspected. The patient was educated about the imperative need to discontinue cocaine use immediately. Additionally, appropriate measures for rate control and anticoagulation were initiated.