RESUMO
La Granulomatosis con Poliangeítis (GPA), o Granulomatosis de Wegener, es una vasculitis sistémica de pequeño y mediano vaso inmunológicamente mediada, que preferentemente compromete la vía aérea superior, pulmones y riñones, y es poco frecuente que se asocie a manifestaciones cardíacas. El compromiso del sistema éxcitoconductor (SEC) es muy raro y se han descrito casos aislados de distintos grados de bloqueo aurículoventricular (BAV). Describimos el caso de un paciente con GPA que durante una recidiva de su enfermedad consultó por disnea, documentándose signos de bajo débito, bradicardia de 30/ min, BAV de 2° grado avanzado y bloqueo completo de rama izquierda (BCRI) en el electrocardiograma (ECG). Se presenta una revisión de la literatura y discutimos sus causas, la evolución y manejo de estos pacientes.
Granulomatosis with Polyangiitis (GPA), or Wegener's Granulomatosis, is an immunologically mediated systemic vasculitis of small and medium vessels, which commonly compromises the upper airway, lungs, and kidneys and is rarely associated with cardiac manifestations. Compromise of the cardiac conduction system is rare, and isolated cases of different degrees of atrioventricular block (AVB) have been described. We report a case of a 49-year-old male patient previously diagnosed with GPA 3 years ago, who presented to the emergency department with dyspnea, clinical signs of low output, bradycardia of 30/min, advanced second-degree AVB and complete left bundle branch block (LBBB) on the ECG. A literature review is presented, and we discuss the causes, evolution, and management of this GPA complication.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Granulomatose com Poliangiite/complicações , Eletrocardiografia , Bloqueio Atrioventricular/etiologiaRESUMO
Granulomatosis with Polyangiitis (GPA), or Wegener's Granulomatosis, is an immunologically mediated systemic vasculitis of small and medium vessels, which commonly compromises the upper airway, lungs, and kidneys and is rarely associated with cardiac manifestations. Compromise of the cardiac conduction system is rare, and isolated cases of different degrees of atrioventricular block (AVB) have been described. We report a case of a 49-year-old male patient previously diagnosed with GPA 3 years ago, who presented to the emergency department with dyspnea, clinical signs of low output, bradycardia of 30/min, advanced second-degree AVB and complete left bundle branch block (LBBB) on the ECG. A literature review is presented, and we discuss the causes, evolution, and management of this GPA complication.