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Published on: March 27, 2018
Exercise-induced Atrioventricular Block with Coronary Artery Stenosis that Appeared Five Years after Bypass Surgery
Shinya Yamazaki1, Taku Kato1, Shunpei Ushimaru1
1Department of Cardiology, Rakuwakai Otowa Hospital, Japan.
Insights
Exercise-induced atrioventricular block is a rare condition that can mimic ischemic heart disease. Prompt diagnosis and stenting resolved symptoms in a patient with coronary artery disease history.
Area of Science:
- Cardiology
- Electrophysiology
- Interventional Cardiology
Background:
- Coronary artery bypass surgery history
- Pre-syncope on effort
- Exercise electrocardiogram test
Observation:
- Advanced atrioventricular block during exercise test
- Associated dizziness
- Significant right coronary artery stenosis
Findings:
- Stenosis not present during prior bypass surgery
- Successful drug-eluting stent implantation
- Resolution of atrioventricular block post-intervention
Implications:
- Exercise-induced atrioventricular block is rare
- Distinguish from ischemic heart disease
- Crucial in patients with coronary artery disease history
Abstract:
A 68-year-old man with a history of coronary artery bypass surgery was referred to our hospital because of pre-syncope on effort. During a treadmill exercise electrocardiogram test, the patient developed advanced atrioventricular block associated with dizziness. Coronary angiography revealed significant stenosis of the right coronary artery, which had not existed at the time of the bypass surgery. We implanted drug-eluting stents in the stenotic lesion, and an exercise test showed resolution of the atrioventricular block. Exercise-induced atrioventricular block is rare, and it is necessary to distinguish it from ischemic heart disease, especially in patients with a history of coronary artery disease.
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