A Case of 2:1 Atrio-Ventricular Block- Unraveled by Exercise Testing
Sharada S. Kalavakolanu1, *, Madan M. Balakrishnan1, Deepesh Venkataraman1
1 Department of Cardiology, MGM Healthcare, Aminjikarai, Chennai, Tamilnadu, India
We present a case of a 75-year-old lady with effort intolerance and baseline ECG showing 2:1 atrioventricular block, in whom it was unclear as to the requirement of permanent pacing, even after long term ECG monitoring. She underwent a treadmill test during which her QRS became wide and developed complete heart block within 2 minutes of the test. Thus, a simple exercise test confirmed the level of the block to be infra nodal without the need for the invasive study. In patients with exertional symptoms, even in elderly, and in those where ECG masquerades as a benign entity, exercise testing is useful to differentiate benign cases of atrioventricular block from the more serious cases that mandate pacemaker implantation.
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* Address correspondence to this author at the Department of Cardiology MGM Healthcare, Nelson Manickam Road, Aminjikarai, Chennai, Tamilnadu, 600029, India; Tel: +91 44 45242444; E-mail: email@example.com
Dr. Abdullah Shehab has 22 years of experience in Internal medicine, cardiology and interventional cardiology and medical education. Currently, he serves as the General Secretary of Emirates Cardiac Society and Vice President of Gulf Intervention Society. He is a Fellow of royal college of physicians UK, American college of physician, European society of cardiology, of American college of cardiology, American society of cardiac intervention and fellow of American heart association. Professor Shehab is the Chief editor of Emirates Medical Journal and also serves as editor in many other regional and international journals. Dr. Shehab has published 149 paper in Medline. His research interest includes: Heart failure, Coronary artery disease, Dyslipidaemia, Hypertension, Arrhythmias, Cardiac intervention, Cardiac imaging, Screening for cardiac disease in sport players, Cardiovascular disease in pregnancy.