Cardiology Department, Hedi Chaker University Hospital, Sfax, Tunisia.
University of Medicine, Sfax, Tunisia.
Pan Afr Med J. 2020 Dec 31;37:391. doi: 10.11604/pamj.2020.37.391.25927. eCollection 2020.
Acute myocarditis represents a challenging diagnosis as there is no pathognomonic clinical presentation. It is rare to see heart block as the first-and-only presentation of infectious myocarditis. We report the case of a young healthy patient who presented with syncope secondary to a complete heart block. It was caused by acute presumed viral myocarditis. The diagnosis was confirmed with cardiac magnetic resonance imaging. With close monitoring, the EKG abnormalities resolved over the following 5 days. In this case report, we present the importance of several imaging tools to diagnose a rare and reversible cause of conduction disturbances. In at-risk individuals, clinicians should rule out a treatable cause of heart block before proceeding with permanent pacemaker implantation due to enormous clinical and cost implications involved.
急性心肌炎的临床表现无特异性，诊断具有挑战性。少见以心脏传导阻滞为首发且唯一表现的感染性心肌炎。我们报告了 1 例以晕厥为首发表现且伴有完全性心脏传导阻滞的年轻健康患者，其病因考虑为急性病毒性心肌炎。心脏磁共振成像有助于明确诊断。经密切监测，患者心电图异常在 5 天后恢复正常。该病例报告强调了多种影像学工具在诊断罕见且可逆转的传导障碍病因中的重要性。对于高危人群，鉴于永久性心脏起搏器植入术的巨大临床和经济影响，在进行该操作之前，临床医生应排除心脏传导阻滞的可治疗病因。
