Sande Kevin, Diaz Oscar, Loyola Guillermo
Internal Medicine, Palmetto General Hospital, Miami, USA.
Osteopathic Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA.
Cureus. 2025 Mar 19;17(3):e80851. doi: 10.7759/cureus.80851. eCollection 2025 Mar.
Complete heart block is a serious cardiac conduction condition marked by the inability of electrical impulses to propagate from the atria to the ventricles. This disorder causes an absence of coordination between the upper and lower chambers of the heart, resulting in various symptoms and possible problems. Complete heart block, also known as third-degree atrioventricular block, is a more severe form of this illness compared to first and second degree. This report describes a 79-year-old man who experienced a rare presentation of complete heart block. The patient had a preexisting condition of hypertension and had been having episodes of dyspnea for the past few months. Although the patient experienced these symptoms, echocardiography did not reveal any evidence of diminished ejection fraction, indicating that the systolic function was preserved. A left cardiac catheterization procedure was conducted, which showed non-occlusive coronary artery disease. Troponin levels were within normal limits, ruling out an acute ischemic event. This finding eliminates the possibility of severe ischemia factors contributing to the patient's condition. An extensive examination of the patient's medication history showed the absence of any drugs that could have caused the total heart block. The decision was reached to proceed with the implantation of a permanent pacemaker. The pacemaker was effectively inserted, resulting in the elimination of the patient's symptoms and stabilization of his heart rhythm.
完全性心脏传导阻滞是一种严重的心脏传导疾病，其特征是电冲动无法从心房传导至心室。这种疾病导致心脏上下腔室之间缺乏协调性，从而引发各种症状和潜在问题。完全性心脏传导阻滞，也称为三度房室传导阻滞，与一度和二度相比，是这种疾病更严重的一种形式。本报告描述了一名79岁男性，他出现了罕见的完全性心脏传导阻滞表现。该患者既往有高血压病史，在过去几个月里一直有呼吸困难发作。尽管患者出现了这些症状，但超声心动图未显示任何射血分数降低的证据，表明收缩功能得以保留。进行了左心导管检查，结果显示为非闭塞性冠状动脉疾病。肌钙蛋白水平在正常范围内，排除了急性缺血事件。这一发现排除了严重缺血因素导致患者病情的可能性。对患者用药史进行的广泛检查表明，不存在任何可能导致完全性心脏传导阻滞的药物。决定继续植入永久性起搏器。起搏器有效植入，患者症状消除，心律稳定。
