Multilevel Conduction Abnormalities: Hickam's Dictum or Occam's Razor?
Sharath K Kumar1, Sheldon M Singh1,2
1Schulich Heart Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
The Journal of Innovations in Cardiac Rhythm Management
|June 29, 2022
Summary
This case report describes pseudo-atrioventricular block caused by concealed His extrasystole in a patient with spinal cord injury. This highlights an unusual electrocardiogram finding mimicking heart block.
Area of Science:
- Cardiology
- Electrophysiology
- Neurology
Background:
- Spinal cord injury can present with complex cardiac manifestations.
- Electrocardiogram (ECG) abnormalities require careful interpretation, especially in patients with neurological conditions.
Observation:
- A 62-year-old woman with a history of spinal cord injury and no prior cardiac disease presented with an abnormal ECG.
- The ECG revealed findings suggestive of concealed His extrasystole.
Findings:
- A systematic ECG evaluation led to the diagnosis of concealed His extrasystole.
- This phenomenon mimicked atrioventricular block, a condition known as pseudo-atrioventricular block.
Implications:
- This case underscores the importance of recognizing concealed His extrasystole as a cause of pseudo-atrioventricular block.
- Understanding this ECG variant is crucial for accurate diagnosis and management in patients with neurological compromise.
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