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Atrioventricular nodal dysfunction secondary to hyperparathyroidism.

Athanasios Vosnakidis¹, Konstantinos Polymeropoulos, Paul Zarogoulidis

¹Department of Cardiology, "George Papanikolaou" General Hospital, Thessaloniki, Greece;

Journal of Thoracic Disease

|July 5, 2013

Summary

This summary is machine-generated.

Hypercalcemia from hyperparathyroidism can cause heart rhythm issues like atrioventricular block. This case suggests calcium deposits in the AV node may be the cause, even after treatment.

Keywords:

Atrioventricular nodal dysfunction hypercalcemia hyperparathyroidism (HPT)

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Area of Science:

Cardiology
Endocrinology
Pathology

Background:

The link between hypercalcemia and bradyarrhythmias is debated.
Hyperparathyroidism is a common cause of hypercalcemia.

Observation:

A 66-year-old presented with dizziness and 2:1 atrioventricular block.
Biochemistry revealed hypercalcemia, low phosphate, and high parathyroid hormone.
Echocardiogram and coronary angiography showed no cardiac abnormalities.

Findings:

The patient experienced persistent symptoms despite hypercalcemia treatment, necessitating pacemaker implantation.
Neck imaging suggested parathyroid adenoma, confirmed by parathyroidectomy.
Degeneration of the atrioventricular node due to calcium deposition is the presumed mechanism.

Implications:

This case highlights a potential mechanism linking hyperparathyroidism-induced hypercalcemia to significant bradyarrhythmias.
It underscores the importance of considering parathyroid evaluation in patients with unexplained heart block.
Further research is needed to elucidate the precise role of calcium deposition in cardiac conduction abnormalities.