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Second and Third Degree Atrioventricular Block with Graves' Disease: A Case Report and Review of the Literature
Author(s) -
MILLER RONALD H.,
CORCORAN FRANCIS H.,
BAKER WILLIAM P.
Publication year - 1980
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1980.tb05575.x
Subject(s) - medicine , atrioventricular block , degree (music) , cardiology , heart block , disease , graves' disease , electrocardiography , physics , acoustics
A previously healthy woman experienced Adams‐Stokes attacks ten weeks after the initiation of antithyroid medication for Graves' disease. The patient manifested advanced atrioventricular (A‐V) block requiring a temporary transvenous pacemaker. The site of heart block was localized to the A‐V node by utilizing a His bundle electrogram. With control of the hyperthyroid state, normal A‐V conduction was restored. Review of the literature identified twenty‐five additional cases of second or third degree A‐V block associated with Graves' disease, ten of whom had Adams‐Stokes syncope or convulsive seizures. The A‐V nodal block was reversible with cure of the primary endocrine disease. It is postulated that excessive thyroid hormone has a direct effect on the cardiac conduction system, specifically, the region of the A‐V node and bundle of His. Recommendations are made regarding the recognition and management of patients at risk for developing heart block associated with Graves' disease.