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Published on: July 25, 2019
A case of myocarditis and associated atrioventricular heart block: a diagnostic conundrum
Louis Graham-Hart1, Wai Nyunt Thinn2, Kaushik Guha3
1Year 1 Internal Medicine Trainee Doctor.
Insights
High-grade atrioventricular (AV) block in myocarditis is rare, posing diagnostic and management challenges. Further research is needed for effective risk stratification and treatment of this heart rhythm disorder.
Area of Science:
- Cardiology
- Electrophysiology
- Myocardial Diseases
Background:
- High-grade atrioventricular (AV) block is uncommon in myocarditis.
- This condition is more typically seen in infiltrative cardiomyopathies.
- Limited data exists on managing heart rhythm disorders in myocarditis patients.
Abstract:
The combination of atrioventricular (AV) block - specifically highgrade AV block- within the setting of myocarditis, is a rarely encountered clinical phenomenon. It is commonly encountered in infiltrative cardiomyopathies but may be associated with myocarditis. Beyond conventional investigation and consideration of endomyocardial biopsy, there is a paucity of data to guide clinicians with regards to the issue of heart rhythm disorder. Options include a 'watch-and-wait' policy, anti-arrhythmic drugs, consideration of a permanent pacemaker or, alternatively, a wearable or implantable cardioverterdefibrillator (ICD). The case encapsulates the difficulties facing clinicians with such pathology and the need to further investigate and risk stratify such patients.
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