Related Experiment Videos
[Complete atrioventricular block secondary to pulmonary embolism]
Julio Martí1, Nuria Casanovas, Luis Recasens
1Servicio de Cardiología, Hospital del Mar, Barcelona, España. jmarti@imas.imim.es
Revista Espanola De Cardiologia
|March 4, 2005
Summary
Pulmonary thromboembolism can cause temporary heart rhythm issues. In a patient with prior left bundle branch block, this condition may have induced transient right bundle branch block, leading to atrioventricular block.
Area of Science:
- Cardiology
- Pulmonology
- Oncology
Background:
- A 73-year-old woman with a history of stable metastatic breast cancer presented with acute dyspnea and presyncope.
- The patient had a known history of left bundle branch block on previous electrocardiograms.
Observation:
- Complete atrioventricular block was diagnosed, necessitating temporary pacemaker implantation.
- Computed tomography revealed bilateral pulmonary thromboembolism.
- Following pacemaker insertion, the patient spontaneously reverted to sinus rhythm with resolution of the atrioventricular block, though the left bundle branch block persisted.
Findings:
- Electrophysiological studies indicated normal atrioventricular conduction.
- The acute presentation was attributed to bilateral pulmonary thromboembolism.
Implications:
- This case suggests pulmonary thromboembolism can precipitate transient conduction abnormalities.
- In patients with pre-existing left bundle branch block, pulmonary embolism may induce transient right bundle branch block, potentially causing atrioventricular block.
- This highlights the importance of considering thromboembolic events in the differential diagnosis of new-onset heart block.