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Computed tomography is important in appropriately diagnosing patients with third-degree atrioventricular block and

Hiroyuki Takaoka1, Nobusada Funabashi1, Koya Ozawa1

  • 1Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.

International Journal of Cardiology
|November 26, 2016
PubMed

Insights

Computed tomography (CT) is more effective than echocardiography (TTE) for diagnosing organic cardiac disease in patients with atrioventricular block (AVB). Combining cardiac and chest CT significantly improves detection rates for cardiac and lung abnormalities.

Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Second- and third-degree atrioventricular block (AVB) can indicate underlying organic cardiac disease.
  • Transthoracic echocardiography (TTE) is a standard imaging modality, but its utility in diagnosing the cause of AVB may be limited.
  • The diagnostic yield of CT in evaluating cardiac and pulmonary abnormalities associated with AVB requires further investigation.

Purpose of the Study:

  • To assess the diagnostic performance of computed tomography (CT) compared to TTE for detecting cardiac and lung abnormalities in patients with second- or third-degree AVB.
  • To determine the prevalence of organic cardiac disease in this patient cohort.
  • To evaluate the added value of combining cardiac and chest CT for diagnosis.

Main Methods:

  • Retrospective analysis of 50 consecutive patients with de novo second- or third-degree AVB.
  • Patients underwent both TTE and cardiac/chest 320-slice CT.
  • Evaluation of left ventricular wall motion, coronary artery stenosis, myocardial late enhancement, lymphadenopathy, and lung nodules.

Main Results:

  • Organic cardiac disease was present in 36% of patients.
  • Cardiac and chest CT detected abnormalities in 36% of patients, compared to 26% for TTE alone.
  • CT identified abnormalities in 18% of patients with normal TTE findings, highlighting its superior sensitivity.

Conclusions:

  • A significant proportion of patients with AVB have underlying organic cardiac disease.
  • TTE alone is insufficient for comprehensive diagnosis in these patients.
  • Combined cardiac and chest CT, or CT in conjunction with TTE, is necessary for accurate diagnosis and management.
Abstract

Keywords:
320 slice CTComputed tomographyOrganic cardiac diseaseSecond-degree atrioventricular block but not Wenckebach typeThird-degree atrioventricular blockTransthoracic echocardiography

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