Related Experiment Videos
Transient heart block associated with head trauma
R Wirth1, P E Fenster, F I Marcus
1Department of Internal Medicine, University of Arizona College of Medicine, Tucson.
Insights
Head trauma can rarely cause atrioventricular nodal block. In a patient with a skull fracture, high-grade atrioventricular block was observed, potentially due to increased vagal tone.
Area of Science:
- Cardiology
- Neurology
- Trauma Medicine
Background:
- Atrioventricular nodal block is an uncommon complication of head injuries.
- Coronary artery disease is a common comorbidity in patients experiencing head trauma.
Observation:
- A 63-year-old male with coronary artery disease sustained a skull fracture.
- Twelve hours post-trauma, the patient experienced high-grade atrioventricular block with a ventricular escape rhythm.
Findings:
- Electrophysiologic evaluation showed no intrinsic abnormalities in atrioventricular or intraventricular conduction.
- The atrioventricular block resolved without intervention, suggesting a transient cause.
Implications:
- Head trauma may precipitate atrioventricular block through mechanisms such as enhanced vagal tone.
- This case highlights the importance of considering cardiac complications in patients with head injuries.
Abstract:
Atrioventricular nodal block is a rare consequence of head trauma. We report a case of a 63-year-old male with coronary artery disease who sustained a skull fracture. Twelve hours later the cardiac monitor recorded an episode of high-grade atrioventricular block with a ventricular escape rhythm. Subsequent electrophysiologic evaluation revealed no abnormality of atrioventricular nodal conduction nor of intraventricular conduction. Atrioventricular block after head trauma may be caused by enhanced vagal tone.