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A degenerative lesion of the approach to the atrioventricular node producing second-degree and third-degree
1Research Laboratory for Cardiovascular Pathology, Juntendo University, Tokyo, Japan.
Insights
Degenerative lesions in the atrial muscle led to progressive atrioventricular (AV) block in an elderly male. This case highlights the impact of conduction system degeneration on cardiac function.
Area of Science:
- Cardiology
- Pathology
Background:
- The case involves an 83-year-old male with pre-existing conditions including diabetes mellitus, hypertension, and ischemic heart disease.
- The patient presented with a documented history of changing electrocardiogram (ECG) findings over 14 years.
Observation:
- The patient's ECGs progressed from first-degree atrioventricular (AV) block to third-degree AV block.
- A pacemaker was implanted due to symptomatic bradycardia.
Findings:
- Post-mortem examination of the conduction system revealed significant degenerative changes.
- Specifically, there was total depletion and fatty replacement of the atrial muscle tissue near the AV node.
Implications:
- This case illustrates a rare degenerative process affecting the cardiac conduction system.
- Such degeneration can lead to severe atrioventricular block and heart failure, necessitating interventions like pacemakers.
Abstract:
We report a case of a degenerative approach lesion in an 83-year-old male with diabetes mellitus, hypertension, and ischemic heart disease. His ECGs changed from first-degree atrioventricular (AV) block 14 years ago, to third-degree AV (A-H) block. A pacemaker was implanted for bradycardia. He died 4 years later from heart and renal failure. Serial sections through the conduction system revealed total depletion and fatty replacement of the atrial muscle at the approaches to the AV node.