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Spontaneous Pneumothorax After Complete Atrioventricular Block in a Patient With Chronic Obstructive Pulmonary
Miho Yamanaka1, Sakiko Honda1, Emi Nishiki2
1Department of Cardiology, Matsushita Memorial Hospital, Moriguchi, JPN.
Abstract:
Pneumothorax arises from a wide variety of causes, and chronic obstructive pulmonary disease (COPD) is the leading cause of secondary spontaneous pneumothorax. We report an 84-year-old man with COPD who presented with breathing difficulty and was found to have a complete atrioventricular block with a ventricular rate of 41 beats per minute, together with a small spontaneous pneumothorax of the left apex. His symptoms had begun six days earlier with a self-reported heart rate of 40 beats per minute, and chest pain with worsening dyspnea developed three days thereafter. The pneumothorax was managed conservatively, and a permanent pacemaker was implanted after temporary pacing, with an uneventful clinical course. Given that cardiac dysfunction can alter the breathing pattern, the present case raises the possibility that the temporal sequence predisposed the emphysematous lung to pneumothorax.
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