系统性硬化症中的完全性心脏传导阻滞：一例病例报告及文献综述
Complete heart block in systemic sclerosis: A case report and literature review.
作者信息
Wang Qinghai, Shang Yinghui, Li Shicheng, Wu Yanxiang, Wang Chenyu, Yan Xiaowei
机构信息
Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing.
Department of Blood Transfusion, The Third Xiangya Hospital, Central South University, Changsha, China.
出版信息
Medicine (Baltimore). 2018 Nov;97(46):e13226. doi: 10.1097/MD.0000000000013226.
RATIONALE
Complete heart block (CHB) is a common clinical manifestation. Systemic sclerosis (SSc) is a rare etiology of CHB that has not received enough attention. Whether pacemaker implantation is required remains inconclusive, especially when patients have no symptoms or mild symptoms of CHB.
PATIENT CONCERNS
In this study, we report the case of a 48-year-old Chinese male who suffers from SSc and CHB.
DIAGNOSE
The patient was previously diagnosed with left anterior hemiblock (LAHB) and right bundle block with normal heart function. CHB was observed on a regular follow-up electrocardiogram (ECG) examination 1 month before his hospitalization.
INTERVENTIONS
A permanent dual chamber pacemaker was implanted.
OUTCOMES
The patient responded well to pacemaker implantation treatment, and his exertional dyspnea disappeared.
LESSONS
The occurrence of heart block associated with SSc often appears concealed. The case highlights the importance of regular follow-up of a patient with SSc. Pacemaker implantation might be unavoidable if CHB is secondary to SSc, even if it is asymptomatic.
理论依据
完全性心脏传导阻滞（CHB）是一种常见的临床表现。系统性硬化症（SSc）是导致CHB的一种罕见病因，尚未得到足够关注。是否需要植入起搏器仍无定论，尤其是当患者没有CHB症状或症状轻微时。
患者情况
在本研究中，我们报告了一名48岁患有SSc和CHB的中国男性病例。
诊断
该患者先前被诊断为左前分支阻滞（LAHB）和右束支阻滞，心功能正常。住院前1个月的常规心电图（ECG）检查发现了CHB。
干预措施
植入了永久性双腔起搏器。
结果
患者对起搏器植入治疗反应良好，劳力性呼吸困难消失。
经验教训
与SSc相关的心脏传导阻滞的发生往往较为隐匿。该病例凸显了对SSc患者进行定期随访的重要性。如果CHB继发于SSc，即使无症状，起搏器植入可能也不可避免。
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