Changuan R Luís, Asenjo G René, Sanhueza G Eduardo, Morris C Raimundo, Ortíz O Mario
Departamento Cardiovascular, Hospital Clínico Universidad de Chile, Santiago, Chile.
Rev Med Chil. 2023 Aug;151(8):1088-1092. doi: 10.4067/s0034-98872023000801088.
Granulomatosis with Polyangiitis (GPA), or Wegener's Granulomatosis, is an immunologically mediated systemic vasculitis of small and medium vessels, which commonly compromises the upper airway, lungs, and kidneys and is rarely associated with cardiac manifestations. Compromise of the cardiac conduction system is rare, and isolated cases of different degrees of atrioventricular block (AVB) have been described. We report a case of a 49-year-old male patient previously diagnosed with GPA 3 years ago, who presented to the emergency department with dyspnea, clinical signs of low output, bradycardia of 30/min, advanced second-degree AVB and complete left bundle branch block (LBBB) on the ECG. A literature review is presented, and we discuss the causes, evolution, and management of this GPA complication.
肉芽肿性多血管炎(GPA),即韦格纳肉芽肿,是一种由免疫介导的中小血管系统性血管炎,通常累及上呼吸道、肺部和肾脏,很少伴有心脏表现。心脏传导系统受累罕见,曾有不同程度房室传导阻滞(AVB)的孤立病例报道。我们报告一例49岁男性患者,3年前被诊断为GPA,现因呼吸困难、低心排血量临床体征、心率30次/分钟、心电图显示二度房室传导阻滞进展及完全性左束支传导阻滞(LBBB)就诊于急诊科。本文进行了文献综述,并讨论了该GPA并发症的病因、病情发展及治疗。