RESUMO
A 50-year-old female patient, presented with repeated syncope for more than 2 years. Prior assessments were conducted at different hospitals, but no definite abnormalities were found. The patient's fear and anxiety about possible future attacks were escalating. Through a Head-up tilt test, the cause was finally identified as vasovagal syncope. Following a 5-min administration of nitroglycerin, the patient reported palpitations, nausea, and deep, rapid breathing. The electrocardiogram initially showed a first-degree atrioventricular block, progressing swiftly to a second-degree type I atrioventricular block-high atrioventricular block. Immediate intervention was undertaken, but blood pressure was not instantly ascertainable, coinciding with an abrupt loss of consciousness. Subsequent electrocardiographic findings included paroxysmal third-degree atrioventricular block, sinus arrest, and complete cardiac arrest, prompting the initiation of external cardiac compressions. The longest recorded ventricular arrest approximated 15 s, with sinus rhythm resuming post 10 s of cardiac compressions and the patient regaining consciousness. The patient underwent vagal ablation and no longer experienced syncope.
Assuntos
Bloqueio Atrioventricular , Síncope Vasovagal , Pessoa de Meia-Idade , Humanos , Feminino , Bloqueio Atrioventricular/complicações , Eletrocardiografia/efeitos adversos , Síncope/diagnóstico , Síncope/etiologia , Síncope/terapia , Síncope Vasovagal/diagnóstico , Síncope Vasovagal/terapia , Síncope Vasovagal/complicações , Arritmias Cardíacas/complicações , Teste da Mesa InclinadaRESUMO
A 30-year-old female patient with 12 weeks of gestation was admitted to our hospital due to dizziness and amaurosis fugax. Moreover, 24 h Holter monitoring showed paroxysmal atrioventricular block (P-AVB) and ventricular arrest. The heart block in the patient was likely a vagally mediated heart block based on the "vagal score." She was not given a pacemaker, and the symptoms and AV nodal conduction were improved following the delivery.
Assuntos
Bloqueio Atrioventricular , Marca-Passo Artificial , Adulto , Bloqueio Atrioventricular/complicações , Bloqueio Atrioventricular/diagnóstico , Bloqueio Atrioventricular/terapia , Nó Atrioventricular , Eletrocardiografia , Feminino , Humanos , Gravidez , GestantesRESUMO
We present a case of paroxysmal atrioventricular block with atrial pacemaker shift, focusing on the change of P-wave morphology.