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Reversible complete heart block in a patient with coronavirus disease 2019

Varun Bhasin1, MaryKate Carrillo1, Bobby Ghosh1

  • 1Division of Cardiology, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.

Pacing and Clinical Electrophysiology : PACE
|July 21, 2021
PubMed

Insights

This case study highlights a rare instance of reversible complete heart block (CHB) in a patient with acute coronavirus disease 2019 (COVID-19). Prompt treatment led to the resolution of CHB, suggesting a potential link between COVID-19 and cardiac arrhythmias.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Internal Medicine

Background:

  • Novel coronavirus (SARS-CoV-2) infection, causing coronavirus disease 2019 (COVID-19), is associated with diverse clinical manifestations.
  • Cardiac arrhythmias represent a spectrum of potential complications in patients with COVID-19.
  • Complete heart block (CHB) is a rare but serious cardiac arrhythmia.

Purpose of the Study:

  • To report an unusual case of reversible complete heart block (CHB) in the context of acute COVID-19.
  • To emphasize the importance of considering COVID-19 in the differential diagnosis of acute CHB.
  • To discuss the potential therapeutic interventions and outcomes.

Main Methods:

  • Case report of a 23-year-old male with a history of Hodgkin's Lymphoma presenting with symptoms of syncope and dizziness.
  • Diagnostic evaluation including electrocardiogram (ECG) revealing complete heart block (CHB).
  • Management involved transvenous pacing, methylprednisolone, and remdesivir administration.

Main Results:

  • The patient presented with symptomatic complete heart block (CHB) and hypotension.
  • Treatment with methylprednisolone and remdesivir resulted in rapid resolution of the CHB.
  • The patient experienced a favorable outcome with the reversal of the cardiac arrhythmia.

Conclusions:

  • COVID-19 should be considered in the differential diagnosis for patients presenting with acute complete heart block (CHB).
  • The mechanism underlying CHB in COVID-19 warrants further investigation.
  • This case demonstrates the potential reversibility of CHB associated with COVID-19 with appropriate medical intervention.

Keywords:
COVID-19arrhythmiacomplete heart blockmyocarditistransvenous pacing

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