title: Resolution of complete heart block after revascularization of acute marginal branch of the right coronary artery.
abstract: A patient presented with typical angina and a non-ST elevation myocardial infarction. Electrocardiogram showed complete heart block, and she was found to have a 90% acute marginal artery stenosis. The block resolved after balloon angioplasty of this artery that does not supply the atrioventricular node. We propose that increased vagal tone due to inferior wall ischemia from acute marginal artery stenosis has elicited the Bezold-Jarisch reflex. This is a likely mechanism for this uncommon etiology of complete heart block.
authors.affiliation: Department of Internal Medicine, Division of Cardiovascular Diseases, University of Tennessee Health Science Center Memphis, Tn, United States.
authors.forename: Oluwaseyi
authors.initials: O
authors.lastname: Bolorunduro
authors.affiliation: Department of Internal Medicine, Division of Cardiovascular Diseases, University of Tennessee Health Science Center Memphis, Tn, United States.
authors.forename: Rami N
authors.initials: RN
authors.lastname: Khouzam
authors.affiliation: Department of Internal Medicine, Division of Cardiovascular Diseases, University of Tennessee Health Science Center Memphis, Tn, United States.
authors.forename: Dwight
authors.initials: D
authors.lastname: Dishmon
mesh_terms: D000328:Adult; D000787:Angina Pectoris / Q000209:etiology; D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D017023:Coronary Angiography; D003331:Coronary Vessels; D003937:Diagnosis, Differential; D004417:Dyspnea / Q000209:etiology; D004562:Electrocardiography; D005260:Female; D006327:Heart Block / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D006801:Humans; D010138:Pacemaker, Artificial