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Reversible second degree atrioventricular block after a severe sickle cell crisis
E Jaeggi1, M Bolens, B Friedli
1Department of Pediatrics, Hôpital Cantonal Universitaire, Geneva, Switzerland.
Pediatric Cardiology
|May 2, 1998
Summary
Sickle cell crisis can cause heart problems, including temporary heart block. This case highlights potential microinfarction in the heart
Area of Science:
- Cardiology
- Hematology
- Medical Case Reports
Background:
- Sickle cell disease (SCD) is prevalent in Black populations, carrying risks for microinfarction.
- Acute myocardial damage during sickle cell vasoocclusive crisis is rarely reported.
- Understanding SCD complications is crucial for patient management.
Observation:
- A unique case of transient second-degree atrioventricular (A-V) block (Mobitz I and II) during a severe sickle cell crisis.
- Radionuclide study (99mTc-MIBI) revealed localized hypoperfusion in the high ventricular septum.
- Echocardiography showed reversible wall motion abnormalities in the same region.
Findings:
- Evidence suggests a localized ischemic event affecting the A-V node and His bundle area.
- This ischemia explains the transient conduction abnormalities observed during the crisis.
- Myocardial damage in sickle cell crisis can manifest as heart block.
Implications:
- Highlights a potentially lethal but underreported complication of sickle cell crisis.
- Emphasizes the need for cardiac monitoring during severe sickle cell events.
- Suggests sickle cell-related hypoperfusion can impact cardiac conduction pathways.