Acute rickettsial myocarditis and advanced atrioventricular block: diagnosis and treatment aided by endomyocardial biopsy.
A case of acute advanced atrioventricular block in a young patient is described. An endomyocardial biopsy performed to confirm myocarditis showed findings compatible with rickettsial endomyocarditis. Treatment with tetracycline was therefore started and a rapid remission of the atrioventricular block was observed. Healing of the disease was subsequently documented by a second endomyocardial biopsy. The rickettsial etiology was confirmed by the results of serial serum titers against Proteus OX-19. Endomyocardial biopsy may be clinically indicated for the diagnosis of advanced atrioventricular block in young patients and may help in their optimal treatment.
D000208:Acute Disease; D000328:Adult; D001706:Biopsy; D006327:Heart Block / Q000150:complications / Q000209:etiology*; D006801:Humans; D008297:Male; D009205:Myocarditis / Q000150:complications / Q000209:etiology* / Q000473:pathology; D009206:Myocardium / Q000473:pathology; D012282:Rickettsia Infections / Q000175:diagnosis