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Cocaine-induced bradyarrhythmia: an unsuspected cause of syncope

V J Castro1, R Nacht

  • 1State University of New York Health Science Center at Brooklyn, Brooklyn, NY, USA.

Chest
|January 13, 2000
PubMed

Insights

Cocaine use can cause serious heart problems, including rare slow heart rhythms (bradyarrhythmias) that may lead to fainting (syncope). Doctors should consider cocaine use when evaluating syncope, particularly in young individuals.

Area of Science:

  • Cardiology
  • Toxicology
  • Emergency Medicine

Background:

  • Cocaine use is linked to numerous adverse health events affecting multiple organ systems.
  • Cardiovascular complications are well-documented, including stroke, myocardial infarction, and sudden cardiac death.
  • Syncope is a recognized symptom of various cocaine-related cardiovascular issues.

Observation:

  • This case highlights a less commonly recognized association between cocaine use and bradyarrhythmias.
  • Bradyarrhythmias, characterized by abnormally slow heart rates, can precipitate syncope.
  • The presenting symptom of syncope prompted the evaluation leading to this observation.

Findings:

  • Cocaine-induced bradyarrhythmias represent a significant, though infrequently reported, cause of syncope.
  • The association requires increased clinical awareness, especially in specific patient demographics.
  • This finding expands the spectrum of known cardiovascular toxicities of cocaine.

Implications:

  • Clinicians must include cocaine use in the differential diagnosis for syncope, particularly in younger patients.
  • Recognizing cocaine-induced bradyarrhythmias can lead to timely diagnosis and intervention.
  • Further research may elucidate the mechanisms and prevalence of this specific cardiovascular complication.

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