Exercise induced complete atrioventricular block: Utility of exercise stress test☆,☆☆
Section snippets
Case
A 76 year old man with long-standing hypertension (on losartan) and diabetes mellitus presented with recurrent episodes of lightheadedness and syncope with physical activity. The patient was asymptomatic at presentation and denied chest pain. He was hemodynamically stable with a heart rate of 67 beats per minute (bpm) and blood pressure of 143/77 mm Hg. Physical exam was unremarkable. ECG showed sinus rhythm with a heart rate of 58 bpm, first degree atrioventricular (AV) block (PR interval 284 ms)
Discussion
Exercise induced complete atrioventricular block (EIAVB) is a relatively uncommon condition and is rarely reported in patients with normal AV conduction at rest [1]. EIAVB may be associated with exercise intolerance and syncope, mimicking the symptoms of other important cardiovascular conditions like arrhythmias, dynamic LV outflow obstruction, aortic stenosis, and CAD. Several mechanisms have been proposed to explain this phenomenon. Many reports suggest that EIAVB is due to a diseased
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Funding sources: None.
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Conflict of interest statement: None of the authors have any conflicts of interest.