Complete Atrioventricular Block after an Anaesthetic Induction in a Patient with Unknown Metabolic Acidosis
Authors/Creators
- 1. Department of Anaesthesiology, Hospital and University Center of Coimbra, Portugal, Portugal
- 2. Department ofCardiology,Hospital and University Center of Coimbra, Portugal, Portugal
Description
Abstract
Clinical case of an 84-year-old female patient who developed a complete heart block a few minutes after anaesthetic induction associated with hemodynamic instability, nonresponsive to vagolytic and adrenergic medication. Transcutaneous pacing was started with hemodynamic improvement. After the event, a decompensated metabolic acidosis was detected which was promptly corrected, leading to a normalization of the heart rhythm. Metabolic acidosis is a described but uncommon cause of atrioventricular block. The authors are not aware of previous report of complete heart block in this context. We would like to draw attention to the importance of choosing carefully which anaesthetic drugs should be used in these cases.
Introduction
Third-degree or complete atrioventricular block is characterized by a transient or permanent alteration in the atrioventricular (AV) conduction system, that interrupts the transmission of the electric impulse from the atria to the ventricles. It can compromise the cardiac output with hemodynamic instability, which can be noncompliant to vagolytic and adrenergic drugs. In these cases, the use of pacemaker can be the last therapeutical resource in order to avoid a progression to a cardiopulmonary arrest.
The purpose of this paper, is to describe a case of a transitory complete heart block (CHB) that took place after a general anaesthesia induction on a patient with no risk factors, which had an unknown metabolic acidosis. The authors are not aware of previous report of complete heart block in this context.
Notes
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IJCMC-5-172.pdf
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- Journal article: https://www.boffinaccess.com/clinical-and-medical-cases/luis-ferreira-ijcmc-5-172 (URL)
- Journal article: https://www.boffinaccess.com/clinical-and-medical-cases/luis-ferreira-ijcmc-5-172/IJCMC-5-172.pdf (URL)
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