Health Dictionary
Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Paroxysmal AV block case study one
Introduction
Overview
A 79 year old woman with multiple comorbidities was diagnosed with paroxysmal AV Block with the help of carotid sinus massage and prolonged ECG monitoring. She was then treatment with a dual chamber pacemaker.
Patient History
A 79‐year‐old hypertensive woman presented with recurrent episodes of syncope over a month, increasing in frequency over the last 3 days.
Diagnosis and Management
- Echocardiography revealed fair left ventricular contractility, mild aortic stenosis, marked mitral annular calcification, mild mitral stenosis and mild mitral regurgitation.
- Baseline ECG was normal.
- Carotid sinus massage triggered a paroxysmal AV block with slowing of sinus rate, associated with near‐syncope;
- During hospital stay, the patient went intermittently into complete AV block,often with near‐syncope;
- The patient was started on isoprenaline infusion at 2 µg/min, with which the episodes subsided.
- Subsequently, a dual‐chamber pacemaker was implanted, with alleviation of symptoms.