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Complete atrioventricular block as an initial manifestation of aortic dissection: A case report

Rodrigo Gopar-Nieto1, Grecia I M Raymundo-Martínez1, Nancy L Chávez-Gómez2

  • 1Servicio de Cardiología, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México.

Cirugia Y Cirujanos
|June 23, 2020
PubMed

Insights

Aortic dissection can obstruct blood flow to the heart's AV node, causing atrioventricular (AV) block. This case highlights the need to consider aortic dissection in hypertensive patients with chest pain and AV block.

Area of Science:

  • Cardiology
  • Vascular Surgery

Background:

  • Aortic dissection is a serious condition involving a tear in the aorta.
  • Right coronary artery involvement in aortic dissection is rare, occurring in 1-2% of cases.
  • Obstruction of the atrioventricular (AV) node's blood supply can lead to heart block.

Observation:

  • A 59-year-old male with hypertension presented with chest pain and complete atrioventricular (AV) block.
  • Diagnostic evaluation revealed Stanford type A aortic dissection.

Findings:

  • The patient's symptoms were consistent with aortic dissection affecting the right coronary artery.
  • Complete AV block was a direct consequence of compromised blood flow to the AV node.

Implications:

  • This case underscores the importance of suspecting aortic dissection in patients presenting with unexplained AV block and chest pain, particularly those with hypertension.
  • Early diagnosis and management of aortic dissection are critical for patient outcomes.
  • Clinicians should consider vascular emergencies in the differential diagnosis of AV block.

Keywords:
Acute aortic syndromesAtrioventricular blockBloqueo auriculoventricularDisección de arteria coronaria derechaRight coronary artery dissectionSíndrome aórtico agudo

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