Cases reported "Heart Block"

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1/1308. Unusual evidence of myocardial involvement during a hypersensitivity reaction to oral penicillin.

    A hypersensitivity reaction to orally administered phenoxymethyl penicillin is reported. The manifestations of the reaction included fever, arthralgia, urticaria and an irregular pulse. Serial ECG showed second-degree atrioventricular block with junctional escape beats, an atypical Wenckebach pattern and, finally, first-degree atrioventricular block with gradually decreasing PR intervals. A normal tracing was recorded on the sixth day despite the persistence of the rash and joint pains.
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keywords = block
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2/1308. Junctional ectopic tachycardia evolving into complete heart block.

    Transition from congenital junctional ectopic tachycardia to complete AV block was observed in an 8 month old girl, over a 36 hour period, during initial hospital admission. Two years later she had evidence of a rapidly increasing left ventricular end diastolic diameter, associated with lowest heart rates during sleep of < 30 beats/min. A transvenous permanent pacemaker was therefore implanted. This finding supports the idea that a pathological process in the area of the AV junction, initially presenting as junctional ectopic tachycardia may later extend to sudden complete atrioventricular block.
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3/1308. atrioventricular block occurring several months after radiofrequency ablation for the treatment of atrioventricular nodal re-entrant tachycardia.

    Atrioventricular (AV) block following radiofrequency (RF) ablation for the treatment of AV nodal re-entrant tachycardia (AVNRT) is a rare but well recognised complication of the procedure--the reported incidence ranges from 1% to 21%. Almost all cases of AV block occur during or shortly after the procedure, are transient, and recover quickly. Two patients (a 22 year man and a 72 year old woman) with symptomatic AV block occurring several months after slow pathway RF ablation, requiring permanent pacemaker implantation, are described. Both patients had had several 24 hour Holter recordings before the procedure, and in neither case was there any evidence of intermittent or persistent AV block. This is a rare complication with no definitive predictors; however, all efforts should be made to exclude AV block in patients presenting with suggestive symptoms following RF ablation. With the wide use of RF ablation for the treatment of AVNRT, more cases are likely to occur. A registry should allow documentation of the incidence of this complication.
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ranking = 4.5
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4/1308. Reversion to sinus rhythm 11 years after surgically induced heart block.

    A patient is presented in whom the heart reverted spontaneously to sinus rhythm 11 years after surgical closure of a ventricular septal defect complicated by complete heart block. It seems unlikely that regeneration of fibres in the bundle of his, if these had indeed been destroyed, could account for the restoration of sinus rhythm after so long an interval.
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ranking = 2.5
keywords = block
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5/1308. Pseudo second degree atrioventricular block with bradycardia. Successful treatment with quinidine.

    Pseudo second degree atrioventricular block resulting from blocked His premature beats was successfully treated with quinidine. The diagnosis was proved by His bundle electrogam which showed both blocked and conducted His premature beats. The blocked His prematures produced second degree atrioventricular block by making the atrioventricular junction refractory. quinidine abolished both conducted and blocked His extrasystoles. There has been no recurrence of arrhythmia during a one-year follow-up.
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ranking = 5
keywords = block
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6/1308. Recurrent miscarriage, congenital heart block and systemic lupus erythematosus.

    We report the obstetric history of a woman, who between 15 spontaneous abortions, gave birth to a child with congenital heart block. She later developed systemic lupus erythematosus, had antibodies to SS-A/Ro and SS-B/La but was repeatedly negative for antiphospholipid antibodies.
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ranking = 2.5
keywords = block
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7/1308. Single-lead VDD pacemaker implantation via persistent left superior vena cava: an improved technique and a new modality.

    Persistent left superior vena cava (PLSVC), which occurs in approximately 0.5% of the general population, may complicate pacemaker implantation by making lead insertion into the right ventricle more difficult and increasing lead instability when the transvenous approach is attempted. We describe our experience with four PLSVC patients with pacemakers. We developed an open J-loop technique in which the stylet tip is directed toward the orifice of the tricuspid valve anteroinferiorly. The lead was implanted into the right ventricular apex without difficulty. Three of our patients had high-degree atrioventricular block and received VVI pacemakers with the new technique. One patient with complete atrioventricular block received a single-lead VDD pacemaker by means of the same technique, with the paired electrodes positioned in the lower right atrium. Excellent results were obtained on exercise tolerance testing, 24-hour Holter monitoring, and echocardiographically determined systolic and diastolic function. This improved technique can simplify pacemaker implantation in patients with PLSVC. The VDD device is a new way to maintain systolic and diastolic function and is an appropriate option in patients with high-degree atrioventricular block and PLSVC who require pacemaker implantation.
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ranking = 1.5
keywords = block
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8/1308. adenosine-induced cardiac pause for endovascular embolization of cerebral arteriovenous malformations: technical case report.

    OBJECTIVE: Extremely high flow through arteriovenous malformations (AVMs) may limit the safety and effectiveness of endovascular glue therapy. To achieve a more controlled deposition of glue, we used transient but profound systemic hypotension afforded by an intravenously administered bolus of adenosine to induce rapidly reversible high-degree atrioventricular block. methods AND CASE REPORT: A patient with a large high-flow occipital AVM fed primarily by the posterior cerebral artery underwent n-butyl cyanoacrylate glue embolization. nitroprusside-induced systemic hypotension did not adequately reduce flow through the nidus, as determined by contrast injection in the feeding artery. In a dose-escalation fashion, boluses of adenosine were administered to optimize the dose and verify that there was no flow reversal in the AVM and no other unexpected hemodynamic abnormalities by arterial pressure measurements and transcranial Doppler monitoring of the posterior cerebral artery feeding the AVM. Thereafter, 64 mg of adenosine was rapidly injected as a bolus to provide 10 to 15 seconds of systemic hypotension (approximately 20 mm Hg). Although there were conducted beats and some residual forward flow through the AVM during this time, the mean systemic and feeding artery pressures were roughly similar and remained relatively constant. A slow controlled injection of n-butyl cyanoacrylate glue was then performed, with excellent filling of the nidus. CONCLUSION: adenosine-induced cardiac pause may be a viable method of partial flow arrest in the treatment of cerebral AVMs. Safe, deep, and complete embolization with a permanent agent may increase the likelihood of endovascular therapy's being curative or may further improve the safety of microsurgical resection.
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ranking = 0.5
keywords = block
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9/1308. Complete atrioventricular block during anesthesia.

    PURPOSE: To describe a case of asymptomatic first degree atrioventricular block with a bifascicular block that progressed to complete atrioventricular block during anesthesia. This potentially fatal block was successfully treated with transesophageal ventricular pacing. CLINICAL FEATURES: A 67-yr-old man was scheduled for microvascular decompression of the right trigeminal nerve under general anesthesia. His preoperative ECG showed first degree atrioventricular block with complete right bundle branch block and left anterior hemiblock, but he had experienced no cardiovascular symptoms. anesthesia was induced with sevoflurane 5%, and maintained with isoflurane 1.5-2% in oxygen. Fifteen minutes later in the left lateral decubitus position, the systolic arterial blood pressure suddenly decreased from 80 mmHg to 0 mmHg. Then, the ECG abruptly changed from sinus rhythm to complete atrioventricular block. The heart was unresponsive to drug therapy such as atropine 1.3 mg and isoproterenol 0.5 mg, or transcutaneous pacing but transesophageal pacing was successful. CONCLUSION: Asymptomatic first degree atrioventricular block with bifascicular block advanced to complete atrioventricular block during anesthesia. The block was successfully managed with transesophageal pacing.
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ranking = 8.0000001338537
keywords = block, nerve
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10/1308. bacillus popilliae endocarditis with prolonged complete heart block.

    bacillus popilliae, a fastidious, aerobic, gram-positive, spore-forming bacillus, has never been reported as a pathogen in human infectious diseases. We report the first case of a human infected by the pathogen B. popilliae, which presented as endocarditis involving the bicuspid aortic valve and complicated with prolonged (> 30 days; to our knowledge, the longest in the literature) complete heart block. Although surgery may be warranted by previous reports, the patient was successfully managed by medical treatment instead, because of the absence of evidence from various approaches that support the existence of perivalvular extension of infection.
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ranking = 2.5
keywords = block
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