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Correlation between Transient Hypotension and Exclusively Exercise-induced Symptoms of Two-to-One Atrioventricular Block |
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| Authors: | Hirofumi Tasaki Shoichi Nagao Reiichiro Nakamizo Yuji Matsumoto Naoto Ashizawa Yoshiyuki Doi Satoki Fukae Hiroaki Kawano Koji Maemura |
| Affiliation: | 1.Department of Cardiovascular Medicine, Nagasaki Genbaku Isahaya Hospital, Japanese Red Cross Society, Japan; 2.Cardiovascular Medicine, Jikei Hospital, Japan; 3.Department of Cardiovascular Medicine, Nagasaki Genbaku Hospital, Japanese Red Cross Society, Japan; 4.Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan |
| Abstract: | A 62-year-old woman with activity-dependent two-to-one atrioventricular block (2:1AVB) and a normal left ventricular ejection fraction was referred to our department for the evaluation of exclusively exercise-induced marked symptoms. The treadmill test helped establish a clear correlation between 2:1AVB and symptoms. The test results demonstrated that exercise-induced marked symptoms were attributed to abrupt transient hypotension combined with relative bradycardia, probably due to increased diastolic mitral and tricuspid regurgitation because of 2:1AVB during moderate-to-heavy exercise. After pacemaker implantation for 2:1AVB, the symptoms and transient hypotension disappeared, and her exercise capacity improved. |
| Keywords: | two-to-one atrioventricular block exclusively exercise-induced symptom transient hypotension normal left ventricular ejection fraction diastolic mitral and tricuspid regurgitation treadmill test |