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Syncope Due to Paroxysmal Atrioventricular Block in a Patient With Systemic Sclerosis: A Case Report

Division of Internal Medicine, Houju Memorial Hospital, Nomi, Ishikawa, Japan, kooe{at}houju.or.jp

Kiyoo Mori, MD

Division of Internal Medicine, Houju Memorial Hospital, Nomi, Ishikawa, Japan

Satoshi Gommori, MD

Division of Internal Medicine, Houju Memorial Hospital, Nomi, Ishikawa, Japan

Tetsuo Konno, MD

Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan

Noboru Fujino, MD

Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan

Masakazu Yamagishi, MD

Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan

A 79-year-old woman with systemic sclerosis was admitted to our hospital because of syncope. On admission, electrocardiogram showed progression of intraventricular conduction defect. Chest radiograph showed marked cardiomegaly. Echocardiogram revealed deterioration of left ventricular systolic function. We suspected progressive myocardial disease with Stokes-Adams attack. When we were preparing a temporary pacemaker, paroxysmal atrioventricular block with asystole for 15 seconds and convulsion occurred. Electrophysiological study showed His-ventricular block and sinus node dysfunction. A permanent pacemaker was implanted. In systemic sclerosis, progression of ventricular conduction defect may warrant prompt electrophysiological study and prophylactic pacemaker implantation.

Key Words: syncope • paroxysmal atrioventricular block • systemic sclerosis • electrophysiological study

This version was published on January 1, 2009

Angiology, Vol. 59, No. 6, 769-771 (2009)
DOI: 10.1177/0003319707307216


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