Does mild symptomatic bradycardia in a young active female need pacemaker?


 

 

Abstract

46 years old women presented suddenly as fainting attack during her work shortly admitted to the emergency department and the initial work-up, a baseline electrocardiogram revealed irregular rhythm at 41 beats per minute (bpm). The patient denied ever having symptoms of presyncope, syncope, or generalized weakness. A Junior doctor in the emergency department treated patient with Amiodaron infusion to a overcome atrial fibrillation. The patient was monitored on telemetry during his 3-day admission and received Amiodaron orally 200mg×3, in addition, had a 48-hour Holter monitoring performed. He was found to have episodes of atrial fibrillation. A thorough history of the patient’s dietary supplements was obtained, none of which were known to cause bradycardia.

Keywords: Bradycardia; Pacemaker; Fainting attack

Copyright © 2013 by The American Society for BioMedicine and BM-Publisher, Inc.

Article citationReferences
The citation data is computed by the following citation measuring services:

Google scholarcitedby

References

  1. Linhart A, Kampmann C, Zamorano JL, et al. Cardiac manifestations of Anderson-Fabry disease: results from the international Fabry outcome survey. Eur Heart J 2007;28:1228-35.
    https://doi.org/10.1093/eurheartj/ehm153
  2. Lobo T, Morgan J, Bjorksten A, Nicholls K, et al. Cardiovascular testing in Fabry disease: exercise capacity reduction, chronotropic incompetence and improved anaerobic threshold after enzyme replacement. Intern Med J 2008;38:407-14.
    https://doi.org/10.1111/j.1445-5994.2008.01669.x
  3. Mehta J, Tuna N, Moller JH, Desnick RJ. Electrocardiographic and vectorcardiographic abnormalities in Fabry's disease. Am Heart J 1977;93:699-705.
    https://doi.org/10.1016/S0002-8703(77)80064-1
  4. Namdar M, Kampmann C, Steffel J, et al. PQ interval in patients with Fabry disease. Am J Cardiol 2010; 105: 753-6.
    https://doi.org/10.1016/j.amjcard.2009.10.056
  5. Senechal M, Germain DP. Fabry disease: a functional and anatomical study of cardiac manifestations in 20 hemizygous male patients. Clin Genet 2003;63:46-52.
    https://doi.org/10.1034/j.1399-0004.2003.630107.x
  6. Shah JS, Hughes DA, Sachdev B, et al. Prevalence and clinical significance of cardiac arrhythmia in Anderson-Fabry disease. Am J Cardiol 2005;96:842-6.
    https://doi.org/10.1016/j.amjcard.2005.05.033
  7. Sheth KJ, Thomas JP Jr. Electrocardiograms in Fabry's disease. J Electrocardiol 1982;15:153-6.
    https://doi.org/10.1016/S0022-0736(82)80010-1
  8. Wu JC, Ho CY, Skali H, Abichandani R, et al. Cardiovascular manifestations of Fabry disease: relationships between left ventricular hypertrophy, disease severity, and alpha-galactosidase A activity. Eur Heart J 2010;31:1088-97.
    https://doi.org/10.1093/eurheartj/ehp588
  9. Frustaci A, Chimenti C. Images in cardiovascular medicine. Cryptogenic ventricular arrhythmias and sudden death by Fabry disease: prominent infiltration of cardiac conduction tissue. Circulation 2007;116:e350-1.
    https://doi.org/10.1161/CIRCULATIONAHA.107.723387
  10. Ikari Y, Kuwako K, Yamaguchi T. Fabry's disease with complete atrioventricular block: histological involvement of the conduction system. Br Heart J 1992;68:323-5.
    https://doi.org/10.1136/hrt.68.9.323
  11. Beck M. The Mainz Severity Score Index (MSSI): development and validation of a system for scoring the signs and symptoms of Fabry disease. Acta Paediatr Suppl 2006; 95: 43-6.
    https://doi.org/10.1080/08035320600618825
  12. Lang RM, Bierig M, Devereux RB, et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr 2005;18:1440-63.
    https://doi.org/10.1016/j.echo.2005.10.005

Research Article

DOI: http://dx.doi.org/10.18081/ajbm/2333-5106-013-11/7-10
American Journal of BioMedicine 2013, Volume 1, Issue 1, pages 7-10
Received 08 September 2013; accepted 25 October 2013; Published 30 December

How to cite this Case reportShwann D. Does mild symptomatic bradycardia in a young active female need pacemaker?. American Journal of BioMedicine 2013;1(1):10-7
Case Report
1. Abstract
2. Keywords
3. Introduction
5. Results
6. Discussion
7. References

Article metric