Prochnau Dirk, Kühnert Helmut, Heyne Jens-Peter, Figulla Hans R, Surber Ralf
Department of Internal Medicine I, Friedrich Schiller University, Jena, Germany.
J Electrocardiol. 2012 Mar;45(2):161-3. doi: 10.1016/j.jelectrocard.2011.05.008. Epub 2011 Jul 8.
Myocarditis is an injury of the myocardium caused by a variety of agents. Conduction disturbances such as complete atrioventricular block (AV block) may occur as an infrequent but serious complication of myocarditis. Early detection and accurate diagnosis of myocarditis are still unresolved challenges. We present 2 cases of otherwise mild myocarditis complicated by high-degree AV block in combination with isolated delayed uptake of contrast at the septal regions in the cardiac magnetic resonance imaging. Because the AV block was persistent in both cases, permanent pacemaker implantation was necessary. Delayed enhancement in the septal area in myocarditis might be predictive of infra-Hisian AV block.
心肌炎是由多种因素引起的心肌损伤。传导障碍，如完全性房室传导阻滞（AV阻滞），可能作为心肌炎罕见但严重的并发症出现。心肌炎的早期检测和准确诊断仍然是尚未解决的挑战。我们报告2例原本轻度的心肌炎，合并高度AV阻滞，且在心脏磁共振成像中室间隔区域出现孤立的对比剂延迟摄取。由于这两例患者的AV阻滞均持续存在，因此需要植入永久性起搏器。心肌炎患者室间隔区域的延迟强化可能预示希氏束下AV阻滞。
