Msirdi Manal, Bouhadoune Youssra, Bazid Zakaria, Ismaili Nabila, Elouafi Noha
Department of Cardiology, Mohammed VI University Hospital, Oujda, Morocco.
Faculty of medicine and pharmacy, University Mohammed I, Oujda, Morocco.
Radiol Case Rep. 2023 Mar 7;18(5):1856-1861. doi: 10.1016/j.radcr.2023.01.096. eCollection 2023 May.
Complete heart block is a commonly encountered entity in clinical cardiology practice, which may be secondary to a variety of diseases including metabolic disorders. Here, we report the case of a 60-year-old female patient who presented with persistent symptomatic complete heart block despite the correction of electrolyte disorder and required admission for permanent pacemaker implantation. The etiologic investigation revealed underlying adrenal insufficiency due to tuberculosis. The clinical and biological presentation of adrenal insufficiency is variable with a difficult etiologic assessment. Although cardiac manifestations are rare, significant electrocardiographic abnormalities can be observed in untreated adrenal insufficiency, such as conduction abnormalities. Hence, in our case, we highlight one of the rare etiologies of conductive disorders and the complexity of the extrapulmonary manifestations of tuberculosis that clinicians should be aware of it.
完全性心脏传导阻滞是临床心脏病学实践中常见的一种情况，它可能继发于包括代谢紊乱在内的多种疾病。在此，我们报告一例60岁女性患者，尽管纠正了电解质紊乱，但仍出现持续性有症状的完全性心脏传导阻滞，需要入院植入永久性起搏器。病因调查显示潜在病因是结核导致的肾上腺功能不全。肾上腺功能不全的临床和生物学表现多样，病因评估困难。虽然心脏表现罕见，但在未经治疗的肾上腺功能不全中可观察到显著的心电图异常，如传导异常。因此，在我们的病例中，我们强调了传导障碍的一种罕见病因以及结核病肺外表现的复杂性，临床医生应予以关注。
