OBJECTIVE: This case presentation describes an uncommon development of complete heart block. Within 48 hours after a motor vehicle accident with the deployment of the air bag against the patient's chest, the patient reported exertional bradycardia and shortness of breath. CLINICAL FEATURES: A 51-year-old man was in a motor vehicle accident. After the collision, he noticed a slow onset of chest discomfort with exertion and bradycardia. The patient experienced cardiac difficulty during a stress electrocardiogram. During the 4 months after the motor vehicle accident, symptoms progressed; and a diagnosis of vagal sympathetic reflex was suggested. INTERVENTION AND OUTCOME: A pacemaker was finally required because of the ventricular pacing of 35 to 40 beats per minute, which was symptomatic of a complete atrioventricular block. CONCLUSION: A gradual progression to complete atrioventricular block over a period longer than 3 weeks is unusual. This case demonstrates that a patient manifesting exertional bradycardia and shortness of breath shortly after chest trauma should be regularly monitored until all symptoms are resolved.
OBJECTIVE: This case presentation describes an uncommon development of complete heart block. Within 48 hours after a motor vehicle accident with the deployment of the air bag against the patient's chest, the patient reported exertional bradycardia and shortness of breath. CLINICAL FEATURES: A 51-year-old man was in a motor vehicle accident. After the collision, he noticed a slow onset of chest discomfort with exertion and bradycardia. The patient experienced cardiac difficulty during a stress electrocardiogram. During the 4 months after the motor vehicle accident, symptoms progressed; and a diagnosis of vagal sympathetic reflex was suggested. INTERVENTION AND OUTCOME: A pacemaker was finally required because of the ventricular pacing of 35 to 40 beats per minute, which was symptomatic of a complete atrioventricular block. CONCLUSION: A gradual progression to complete atrioventricular block over a period longer than 3 weeks is unusual. This case demonstrates that a patient manifesting exertional bradycardia and shortness of breath shortly after chest trauma should be regularly monitored until all symptoms are resolved.
Authors: M S Link; P J Wang; N G Pandian; S Bharati; J E Udelson; M Y Lee; M A Vecchiotti; B A VanderBrink; G Mirra; B J Maron; N A Estes Journal: N Engl J Med Date: 1998-06-18 Impact factor: 91.245
Authors: Tareq Maraqa; Mohamed A T Mohamed; Kenneth L Wilson; Vinu Perinjelil; Gul R Sachwani-Daswani; Leo Mercer Journal: J Cardiothorac Surg Date: 2019-02-04 Impact factor: 1.637