Dianzumba S B, Singer D H, Meyers S, Barresi V, Belic N, Smith J M
Am Heart J. 1977 Oct;94(4):479-85. doi: 10.1016/s0002-8703(77)80043-4.
The case of a 22-year-old white male without known heart disease who presented with activity related lightheadedness at age 19 and dizziness and fatigue at age 21 is described. Standard electrocardiograms (ECG's) revealed intermittent complete trifascicular block. Rapid progression of symptoms over the succeeding eight months resulted in increasing incapacity. Holter monitoring demonstrated that symptoms were related to development of second and higher degrees of A-V block. Normal A-H interval and markedly prolonged H-Q interval on His bundle electrograms indicated that block was infranodal and localized to bundle branch system. Conduction problems aside, clinical and laboratory evaluation, including echocardiograms and cardiac catheterization, were unremarkable. Progression of bilateral bundle branch disease in a young patient without other demonstrable heart lesions and a negative family background conforms with criteria for Lenegre's disease. To our knowledge, this represents the youngest reported patient with this entity. Possible electrophysiologic basis of block and of exercise induced improvement in A-V conduction also are considered.
本文描述了一名22岁无已知心脏病史的白人男性病例，该患者19岁时出现与活动相关的头晕，21岁时出现头晕和疲劳。标准心电图显示间歇性完全性三分支阻滞。在随后的八个月中症状迅速进展，导致功能丧失加剧。动态心电图监测表明症状与二度及更高程度的房室传导阻滞的发展有关。希氏束电图显示A-H间期正常，H-Q间期明显延长，表明阻滞位于结下，局限于束支系统。除传导问题外，包括超声心动图和心导管检查在内的临床和实验室评估均无异常。一名年轻患者双侧束支疾病进展，无其他明显心脏病变且家族史阴性，符合勒内格雷病的标准。据我们所知，这是报道的该疾病最年轻的患者。还考虑了阻滞以及运动诱发的房室传导改善的可能电生理基础。
