Raboud, Matthieu; Humm, Andrea M; Vivekanantham, Hari; Suter, Philipp (2023). Transient central hypoxemia due to intermittent high-degree atrioventricular block in a heart-transplanted patient diagnosed during routine electroencephalography: a case report. Journal of medical case reports, 17(1), p. 3. BioMed Central 10.1186/s13256-022-03574-6
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BACKGROUND
Bradycardia frequently occurs in heart-transplanted patients, mainly as a temporally restricted manifestation early after transplantation and often without symptoms. A high-degree atrioventricular block is mostly symptomatic through cerebral hypoxia induced through cerebral hypoperfusion. Only a few published cases show this specific electroencephalography result in this context. The purpose of this case is to bring attention to atypical manifestations of typical cardiac complications after heart transplantation and the importance of perseverance in the diagnostic.
CASE PRESENTATION
A Central European man in his 50s with history of heart transplantation 31 years previously was admitted to the internal medicine ward for short-lived recurrent episodes of generalized weakness with multiple falls but without loss of consciousness. During routine electroencephalography, the patient perceived this recurrent sensation. This episode coincided with a transient third-degree atrioventricular block followed 8-10 seconds later by a generalized slowing of the electroencephalography, reflecting cerebral hypoxia due to cerebral hypoperfusion. Holter monitoring confirmed the diagnosis. A pacemaker was implanted, consequently resolving the episodes.
CONCLUSION
This case report illustrates the pathophysiological central hypoxemic origin of episodes of generalized weakness caused by a high-degree atrioventricular block in a patient surviving 29 years after heart transplant. It highlights the benefit of electroencephalography as a diagnostic tool in well-selected patients.
Item Type: |
Journal Article (Further Contribution) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Pneumology |
UniBE Contributor: |
Suter, Philipp |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1752-1947 |
Publisher: |
BioMed Central |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
06 Jan 2023 10:24 |
Last Modified: |
08 Jan 2023 02:11 |
Publisher DOI: |
10.1186/s13256-022-03574-6 |
PubMed ID: |
36604735 |
Uncontrolled Keywords: |
Cerebral hypoperfusion Cerebral hypoxemia Heart transplantation High-degree atrioventricular block |
BORIS DOI: |
10.48350/176939 |
URI: |
https://boris.unibe.ch/id/eprint/176939 |
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