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An Intriguing Family with Type 2 Diabetes Mellitus and Complete Heart Block

Gaurav Agarwal1, Satish Kumar Singh1

  • 1Department of Medicine, Nalanda Medical College Hospital, Patna, Bihar, India.

Indian Journal of Endocrinology and Metabolism
|October 10, 2017
PubMed

Insights

Type 2 Diabetes Mellitus (T2DM) can lead to spontaneous Complete Heart Block (CHB) even without heart disease. Genetic factors may play a significant role in this association.

Area of Science:

  • Cardiology
  • Endocrinology
  • Genetics

Background:

  • Chronic hyperglycemia in Type 2 Diabetes Mellitus (T2DM) is linked to cardiovascular complications like coronary artery disease (CAD) and heart failure.
  • Complete Heart Block (CHB) is a serious cardiac condition affecting heart rate and rhythm.

Observation:

  • A 62-year-old male with T2DM presented with sudden giddiness and loss of consciousness.
  • The patient had a strong family history of T2DM and spontaneous CHB.
  • Cardiovascular examination revealed bradycardia (pulse rate 36/min); ECG confirmed CHB, while echocardiography showed normal ventricular function without ischemic heart disease.

Findings:

  • The case highlights spontaneous onset CHB in a T2DM patient without evidence of ischemic heart disease.
  • Cardiac Autonomic Neuropathy (CAN) is proposed as the likely cause of CHB.
  • Both diabetes control and genetic predisposition are suggested as contributing factors to CAN and CHB.

Implications:

  • This case underscores the importance of considering CHB in T2DM patients, even in the absence of typical cardiac risk factors.
  • Early diagnosis and management of CAN in T2DM patients may be crucial for preventing severe cardiac events.
  • Further research into the genetic underpinnings of T2DM-associated cardiac autonomic dysfunction is warranted.

Keywords:
Complete Heart BlockKearns-Sayre syndromeQTc intervalType 2 Diabetes Mellitus

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