Postprandial atrioventricular block in a patient with diabetes mellitus.
Postprandial atrioventricular (AV) block and hypotension occurred in an 80-year-old man with a 13-year history of diabetes mellitus. Two weeks before admission, he experienced syncope on two occasions after lunch. Master's two-step test induced second degree AV block (2:1 block). Four days after admission, syncope recurred while walking 1 hour after eating; electrocardiogram (ECG) showed complete AV block following 2:1 block. PP interval analysis suggested phase 3 block as the mechanism of AV block. Electrophysiologic study revealed 2:1 HV block. Postprandial syncope ceased after permanent pacemaker implantation. Postprandial AV block and hypotension merit close attention in diabetics.
Okamoto
M
M
Department of Cardiology, Hiroshima Prefectural Hospital.
Hashimoto
M
M
Yamada
T
T
Sueda
T
T
Ohishi
Y
Y
Karakawa
S
S
D000368:Aged; D000369:Aged, 80 and over; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000503:physiopathology*; D004562:Electrocardiography; D006327:Heart Block / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D007022:Hypotension / Q000209:etiology / Q000503:physiopathology; D008297:Male; D010138:Pacemaker, Artificial; D019518:Postprandial Period; D013575:Syncope / Q000209:etiology / Q000503:physiopathology / Q000628:therapy