Abstract
We present a case of a 75-year-old lady with effort intolerance and baseline ECG showing 2:1 atrioventricular block, in whom it was unclear as to the requirement of permanent pacing, even after long term ECG monitoring. She underwent a treadmill test during which her QRS became wide and developed complete heart block within 2 minutes of the test. Thus, a simple exercise test confirmed the level of the block to be infra nodal without the need for the invasive study. In patients with exertional symptoms, even in elderly, and in those where ECG masquerades as a benign entity, exercise testing is useful to differentiate benign cases of atrioventricular block from the more serious cases that mandate pacemaker implantation.
Keywords: Atrioventricular block, Complete heart block, Exercise test, Intra-Hisian block, Infra nodal, Coronary angiogram.
New Emirates Medical Journal
Title:A Case of 2:1 Atrio-Ventricular Block- Unraveled by Exercise Testing
Volume: 1 Issue: 2
Author(s): Sharada S. Kalavakolanu*, Madan M. Balakrishnan and Deepesh Venkataraman
Affiliation:
- Department of Cardiology, MGM Healthcare, Aminjikarai, Chennai, Tamilnadu,India
Keywords: Atrioventricular block, Complete heart block, Exercise test, Intra-Hisian block, Infra nodal, Coronary angiogram.
Abstract: We present a case of a 75-year-old lady with effort intolerance and baseline ECG showing 2:1 atrioventricular block, in whom it was unclear as to the requirement of permanent pacing, even after long term ECG monitoring. She underwent a treadmill test during which her QRS became wide and developed complete heart block within 2 minutes of the test. Thus, a simple exercise test confirmed the level of the block to be infra nodal without the need for the invasive study. In patients with exertional symptoms, even in elderly, and in those where ECG masquerades as a benign entity, exercise testing is useful to differentiate benign cases of atrioventricular block from the more serious cases that mandate pacemaker implantation.
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Cite this article as:
Kalavakolanu S. Sharada*, Balakrishnan M. Madan and Venkataraman Deepesh , A Case of 2:1 Atrio-Ventricular Block- Unraveled by Exercise Testing, New Emirates Medical Journal 2020; 1 (2) . https://dx.doi.org/10.2174/0250688202002022001
DOI https://dx.doi.org/10.2174/0250688202002022001 |
Print ISSN 0250-6882 |
Publisher Name Bentham Science Publisher |
Online ISSN 0250-6882 |
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