Systemic Diseases and Heart Block

Syed Rafay A Sabzwari; Wendy S Tzou

doi:10.1016/j.ccl.2023.03.008

Systemic Diseases and Heart Block

Cardiol Clin. 2023 Aug;41(3):429-448. doi: 10.1016/j.ccl.2023.03.008.

Authors

Syed Rafay A Sabzwari¹, Wendy S Tzou²

Affiliations

¹ University of Colorado Anschutz Medical Campus, 12631 East 17th Avenue, Mail Stop B130, Aurora, CO 80045, USA.
² Cardiac Electrophysiology, University of Colorado Anschutz Medical Campus, 12401 E 17th Avenue, MS B-136, Aurora, CO 80045, USA. Electronic address: Wendy.Tzou@cuanschutz.edu.

PMID: 37321693
DOI: 10.1016/j.ccl.2023.03.008

Abstract

Systemic diseases can cause heart block owing to the involvement of the myocardium and thereby the conduction system. Younger patients (<60) with heart block should be evaluated for an underlying systemic disease. These disorders are classified into infiltrative, rheumatologic, endocrine, and hereditary neuromuscular degenerative diseases. Cardiac amyloidosis owing to amyloid fibrils and cardiac sarcoidosis owing to noncaseating granulomas can infiltrate the conduction system leading to heart block. Accelerated atherosclerosis, vasculitis, myocarditis, and interstitial inflammation contribute to heart block in rheumatologic disorders. Myotonic, Becker, and Duchenne muscular dystrophies are neuromuscular diseases involving the myocardium skeletal muscles and can cause heart block.

Keywords: Amyloidosis; Atrioventricular node; Heart block; Muscular dystrophies; Rheumatologic disorders; Sarcoidosis; Systemic lupus erythematosus; Thyroid disorders.

Publication types

Review

MeSH terms

Arrhythmias, Cardiac
Arthritis, Rheumatoid* / complications
Heart Block / complications
Heart Diseases* / etiology
Humans
Muscular Dystrophies* / complications
Myocarditis* / complications
Myocardium