Complete atrioventricular block caused by pulmonary embolism: A case report and review of literature |
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| Institution: | 1. Department of Internal Medicine, Staten Island University Hospital- Northwell Health, 475 Seaview Avenue, Staten Island, NY, USA;2. Department of Cardiology, Staten Island University Hospital-Northwell Health, 475 Seaview Avenue, Staten Island, NY, USA;1. Department of Neurology, The Affiliated Hospital of Yangzhou University, No. 368, Hanjiang Road, Yangzhou, Jiangsu 225000, China;2. Department of Cardiology, The Affiliated Hospital of Yangzhou University, No. 368, Hanjiang Road, Yangzhou, Jiangsu 225000, China;1. Oregon Health & Science University School of Nursing, SN-ORD, 3455 S.W. U.S. Veterans Hospital Road Portland, OR 97239-2941, USA;2. University of California Davis Betty Irene Moore School of Nursing, Sacramento, CA, USA;3. Providence Heart & Vascular Institute, Portland, OR, USA;4. Providence Sacred Heart Medical Center, Spokane, WA, USA;5. University of North Carolina, REX Healthcare, Raleigh, NC, USA;6. Boston College William F. Connell School of Nursing, Chestnut Hill, MA, USA;1. Department of Medicine, North Shore Medical Center, Salem, MA, United States;2. Department of Medicine, Tufts University Medical School, Boston, MA, United States;3. School of Public Health, University of Massachusetts Lowell, Lowell, MA, United States;4. University of Kentucky College of Medicine, Division of Hospital Medicine, Lexington, KY, United States;5. Department of Medicine, Englewood Hospital and Medical Center, Englewood, NJ, United States;6. Department of Medicine, St. Luke''s Hospital, Chesterfield, MO, United States;7. Brandeis University, Waltham, MA, United States;8. St. Cloud State University, Plymouth, MN, United States;9. Division of Cardiology, University of Tennessee Health Science Center, Memphis TN, United States;10. WJB Dorn VAMC Heart and Vascular Institute/USC School of Medicine, Columbia, SC, United States;1. Radiology Department, University Hospital Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, United States;1. Department of Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, WA, USA;2. Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA;3. Department of Neurology, University of Washington, Seattle, WA, USA;1. Department of Internal Medicine, University of Nevada Reno School of Medicine, 1155 Mill St, W-11, Reno, NV 89502, United States;2. Department of Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States;3. Department of Internal Medicine, Mercy St. Vincent Medical Center, Toledo, OH, USA;4. Department of General Medicine, Gotri Medical Education and Research Center, Vadodara, Gujarat, India |
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| Abstract: | IntroductionAcute electrocardiogram abnormalities are common in patients afflicted with pulmonary embolism (PE). Rarely, a patient with acute pulmonary embolism and electrocardiogram changes may have an underlying conduction abnormality that complicates their course.Case presentationWe describe a patient with known history of left bundle branch block who presented with acute PE and developed a right bundle branch block, which devolved into complete third degree heart block without ventricular escape rhythm and led to concomitant hemodynamic compromise.DiscussionGiven the rarity of this clinical scenario, we call for clinicians to be aware of PE-associated conduction pathology as well as the possibility that malignant cardiac conduction blocks may occur in the setting of PE particularly if the patient is known to have underlying conduction system disease. We emphasize the importance of continuous telemetry monitoring in patients presenting with PE as these types of arrhythmic complications and hemodynamic decompensation has been observed. |
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