A 60-year-old with heart failure symptoms due to 1st degree AV-Block caused by granulomatosis with polyangiitis (Wegener's granulomatosis)

Journal of Cardiology Cases
Davit SaghabalyanSven Lerch

Abstract

Granulomatosis with polyangiitis is a rare systemic inflammatory disorder mainly affecting the small vessels. Cardiac involvement is rare, conduction delay being the most rare one. This case reports on a middle-aged male patient with heart failure symptoms due to a 1st degree atrioventricular block with a marked PR prolongation of 480 ms on electrocardiography (ECG). Because of heart failure symptoms as well as elevated N-terminal pro-B-type natriuretic peptide and no other relevant findings in the blood test it was initially planned to treat the conduction disorder with a pacemaker. During further investigations a certain diagnosis of granulomatosis with polyangiitis was determined. After administration of high-dose steroids a complete clinical remission of heart failure symptoms and normal conduction on ECG were demonstrated, so that no pacemaker therapy was needed. <Learning objective: Although atrioventricular (AV) conduction disorders have been described previously in patients with granulomatosis with polyangiitis, this is the first case reporting of vasculitis causing heart failure symptoms due to non-severe conduction disorder such as 1st degree AV-block. Even in the case of non-severe AV conduction delay, which causes s...Continue Reading

References

Oct 1, 1991·Pediatric Cardiology·B N Agarwala, D G Ruschhaupt
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May 3, 2015·The Journal of Rheumatology·Lucy McGeochUNKNOWN Vasculitis Clinical Research Consortium
May 20, 2016·Intractable & Rare Diseases Research·Buraa KubaisiC Stephen Foster

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