Paroxysmal AV block case study one
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Overview
A 79 year old woman with multiple comorbidities was diagnosed with paroxysmal AV Block with the help of carotid sinus massage and prolonged ECG monitoring. She was then treatment with a dual chamber pacemaker.
Patient History
A 79‐year‐old hypertensive woman presented with recurrent episodes of syncope over a month, increasing in frequency over the last 3 days.
Diagnosis and Management
- Echocardiography revealed fair left ventricular contractility, mild aortic stenosis, marked mitral annular calcification, mild mitral stenosis and mild mitral regurgitation.
- Baseline ECG was normal.
- Carotid sinus massage triggered a paroxysmal AV block with slowing of sinus rate, associated with near‐syncope;
- During hospital stay, the patient went intermittently into complete AV block,often with near‐syncope;
- The patient was started on isoprenaline infusion at 2 µg/min, with which the episodes subsided.
- Subsequently, a dual‐chamber pacemaker was implanted, with alleviation of symptoms.