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Complete atrioventricular block and infective endocarditis in a patient with hypertrophic obstructive cardiomyopathy

Takuji Katayama1, Yoshio Tsuruya, Susumu Ishikawa

  • 1Division of Cardiology, Tokyo Kita Social Insurance Hospital, Japan. taku-iku-mm@fa2.so-net.ne.jp

Internal Medicine (Tokyo, Japan)
|April 3, 2012
PubMed

Insights

Hypertrophic obstructive cardiomyopathy (HOCM) patients with pre-existing conduction disturbances face a rare risk of complete atrioventricular (AV) block. Recognizing these blocks is crucial for preventing life-threatening cardiac events.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiovascular Surgery

Background:

  • Hypertrophic obstructive cardiomyopathy (HOCM) is a complex cardiac condition.
  • Patients with HOCM can present with various conduction abnormalities.
  • Infective endocarditis adds significant risk in cardiac patients.

Observation:

  • A 62-year-old male HOCM patient experienced complete atrioventricular (AV) block and cardiac arrest.
  • Previous electrocardiogram showed a bifascicular block pattern.
  • The patient also had native aortic valve infective endocarditis.

Findings:

  • Complete AV block occurred in an HOCM patient without procedural cause.
  • Surgical intervention included dual-chamber pacing, myectomy, and aortic valve replacement.
  • The patient's pre-existing bifascicular block was a precursor to complete AV block.

Implications:

  • Complete AV block is a rare but potentially fatal complication in HOCM.
  • Early identification of cardiac conduction disturbances is vital in HOCM management.
  • Proactive monitoring and intervention can mitigate risks associated with AV block in HOCM.

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