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Dialysis-Reversible Complete Heart Block Without Severe Metabolic Derangements
Shai Ring1,2, Alexander Llop1,2, Harris Khawaja3,2
1Internal Medicine, Hospital Corporation of America (HCA) Houston Healthcare - Kingwood, Kingwood, USA.
An elderly woman with kidney injury experienced intermittent complete heart block. Hemodialysis temporarily resolved the condition, necessitating a permanent pacemaker for sustained heart rhythm management.
Area of Science:
- Nephrology
- Cardiology
- Electrophysiology
Background:
- Acute kidney injury (AKI) can present with complex electrolyte disturbances and cardiac complications.
- Complete heart block (CHB) is a serious arrhythmia requiring prompt management.
Observation:
- An elderly female presented with dizziness secondary to acute kidney injury and complete heart block.
- Initial transvenous pacing and hemodialysis (HD) temporarily resolved the CHB.
Findings:
- Recurrence of CHB was observed the following day, again responsive to hemodialysis.
- Electrophysiology consultation led to permanent pacemaker implantation for definitive treatment.
Implications:
- This case highlights the potential link between severe kidney injury and reversible cardiac conduction abnormalities.
- Management requires a multidisciplinary approach involving nephrology, cardiology, and electrophysiology.
- Temporary pacing and hemodialysis can be crucial in managing acute CHB associated with kidney disease, but permanent solutions may be necessary.
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