Occurrence of complete heart block associated with acute renal infarction

Ann Noninvasive Electrocardiol. 2019 Sep;24(5):e12674. doi: 10.1111/anec.12674. Epub 2019 Jul 29.

Abstract

Complete heart block (CHB) and acute renal infarction (ARI) are both uncommon diseases and seldom encountered in the clinical practice. We describe a rare case of pre-existing left bundle branch block, presenting simultaneously with CHB and ARI. The possible mechanism depends on prior presence of either CHB or ARI. If ARI occurs first, severe pain and embolism may enhance the vagal tone resulting in decrease in the heart rate and transient intraventricular conduction interruption, which subsequently causes CHB. The opposite scenario, CHB preceding ARI, is also possible. CHB can be physiologic and transient, with higher risk of development in the circumstance of pre-existing conduction system disturbances. Patients with CHB are predisposed to formation of thrombi and thromboemboli, giving rise to ARI. In conclusion, awareness and timely identification of the clinical manifestations of these two diseases may facilitate early diagnosis and prompt management.

Keywords: atrioventricular conduction block; bundle branch block; complete heart block; renal infarction.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Bundle-Branch Block / complications*
  • Bundle-Branch Block / diagnostic imaging
  • Bundle-Branch Block / therapy
  • Electrocardiography
  • Heart Block / diagnostic imaging
  • Heart Block / etiology*
  • Heart Block / therapy
  • Humans
  • Infarction / diagnostic imaging
  • Infarction / etiology*
  • Infarction / therapy
  • Kidney Diseases / diagnostic imaging
  • Kidney Diseases / etiology*
  • Kidney Diseases / therapy
  • Male
  • Renal Artery