University of Colorado Anschutz Medical Campus, 12631 East 17th Avenue, Mail Stop B130, Aurora, CO 80045, USA.
Cardiac Electrophysiology, University of Colorado Anschutz Medical Campus, 12401 E 17th Avenue, MS B-136, Aurora, CO 80045, USA.
Card Electrophysiol Clin. 2021 Dec;13(4):721-740. doi: 10.1016/j.ccep.2021.06.011.
Systemic diseases can cause heart block owing to the involvement of the myocardium and thereby the conduction system. Younger patients (<60) with heart block should be evaluated for an underlying systemic disease. These disorders are classified into infiltrative, rheumatologic, endocrine, and hereditary neuromuscular degenerative diseases. Cardiac amyloidosis owing to amyloid fibrils and cardiac sarcoidosis owing to noncaseating granulomas can infiltrate the conduction system leading to heart block. Accelerated atherosclerosis, vasculitis, myocarditis, and interstitial inflammation contribute to heart block in rheumatologic disorders. Myotonic, Becker, and Duchenne muscular dystrophies are neuromuscular diseases involving the myocardium skeletal muscles and can cause heart block.
系统性疾病可因心肌和传导系统受累而导致心脏阻滞。年轻患者（<60 岁）出现心脏阻滞时，应评估是否存在潜在的系统性疾病。这些疾病可分为浸润性、风湿性、内分泌性和遗传性神经肌肉退行性疾病。淀粉样变性纤维和心脏结节病的非干酪性肉芽肿可浸润传导系统导致心脏阻滞。加速性动脉粥样硬化、血管炎、心肌炎和间质炎症导致风湿性疾病出现心脏阻滞。肌强直性、贝克和杜兴氏肌肉营养不良症是累及心肌、骨骼肌的神经肌肉疾病，可导致心脏阻滞。
