Variable atrioventricular block in systemic lupus erythematosus.
Systemic lupus erythematosus (SLE), a connective tissue disease characterized by the production of auto-antibodies and immune complexes, can affect all organs including the heart. The involvement of the conduction system in SLE has been less commonly described. We report a case of an asymptomatic 45-year-old woman with SLE referred to the emergency department (ED) for thrombocytopenia, and was found to have alternating first- and second-degree atrioventricular block (AVB) during routine electrocardiographic screening for hospital admission. Serial electrocardiograms (ECG) done in the ED when compared to those recorded 24 h prior revealed progression from mild first-degree AVB (PR interval = 216 ms) to significant first-degree AVB (PR interval = 510 ms), followed by second-degree AVB (Mobitz type I-Wenckebach phenomenon). The conduction abnormalities recorded over a 28-h period resolved with corticosteroid treatment. Review of the literature on the disruption of the cardiac conduction system in SLE is discussed.
Liautaud
Sybille
S
Division of Pulmonary and Critical Care, Department of Medicine, Mount Sinai School of Medicine, 164-04, 85th Avenue, Jamaica, NY 11432, USA. lsybille67@hotmail.com
Khan
Ahmed J
AJ
Nalamasu
Shireesha R
SR
Tan
Irene J
IJ
Onwuanyi
Anekwe E
AE
D004562:Electrocardiography; D005260:Female; D006327:Heart Block / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors