Case Report of High-Grade Atrioventricular Block and Takotsubo Cardiomyopathy

Prasad, Rohan; Salam, Mohammad Fahad; Srivastava, Shaurya; Samreen, FNU; Baloch, Zulfiqar Qutrio

doi:10.7812/tpp/21.006

Cited by 1 publication

(1 citation statement)

References 13 publications

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“…[86][87][88][89] In patients with persistent AV block, a permanent pacemaker is implanted. 90 Importantly, any bradyarrhythmia, including complete AV block, may facilitate or trigger the occurrence of TdP via the mechanism of long-short sequence. [91][92][93] Hence, any patient with high-degree or complete AV block should have a temporary pacemaker inserted, even if hemodynamically stable, and until AV conduction resumes or a permanent pacemaker is implanted.…”

Section: Cardiac Rupturementioning

confidence: 99%

Takotsubo Syndrome and Sudden Cardiac Death

Manolis

Manolis²,

Melita

et al. 2022

Angiology

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Takotsubo syndrome (TTS), triggered by intense emotional or physical stress, occurring most commonly in post-menopausal women, presents as an ST-elevation myocardial infarction (MI). Cardiovascular complications occur in almost half the patients with TTS, and the inpatient mortality is comparable to MI (4–5%) owing to cardiogenic shock, myocardial rupture, or life-threatening arrhythmias. Thus, its prognosis is not as benign as previously thought, as it may cause mechanical complications (cardiac rupture) and potentially lethal arrhythmias and sudden cardiac death (SCD). Similar to MI, some patients may perish before reaching the hospital due to out-of-hospital cardiac arrest; this may lead to underestimation of the actual SCD risk. Furthermore, after discharge, some patients may develop late SCD and/or TTS recurrence that may result in SCD. There are risk factors for SCD in TTS patients, such as severe/persistent QT-interval prolongation inciting torsade-de-pointes, other ECG abnormalities (diffuse giant negative T-waves, widened QRS-complex), bradyarrhythmias, comorbidities, concurrent obstructive coronary artery disease or vasospasm, male gender, older age, severe left ventricular dysfunction, and use of sympathomimetic drugs. All these issues are herein reviewed, case reports/series and data from large cohort studies and meta-analyses are analyzed, risk factors are tabulated, and proarrhythmic effects and management strategies are discussed and pictorially illustrated.

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