Transient alternating infrahisian system conduction defects
Argentina
Case presentation
59 male patient presented for consultation due to diarrheic scenario with 5 days of evolution.
Personal history: Mild hypertension, in use of Losartan 25 mg, 2x per day. He refers to be carrier of Chagas disease.
Family history: Negative for sudden cardiac death or cardiac arrhythmias.
Social history: Negative for tobacco, alcohol abuse or illicit drugs.
Physical examination: Blood Pressure: 130-80 mmHg. Nothing worthy of note.
Several ECGs were performed at the consultation. He brought with him two ECGs performed in December 2015.
Emergency laboratory tests were requested that revealed just moderate hypokalemia (potassium serum level 2.8 mEq/L).
Echocardiogram: Mild eccentric left ventricular hypertrophy with preserved ventricular function, normal LV ejection fraction (55%), LV with diastolic dysfunction pattern, normal left ventricular diastolic diameter (55 mm). Left atrium with mild dilatation (48 mm). Right ventricular with normal systolic function and diameter. Normal root diameter of the aorta (36 mm).
Questions
1. Describe the evolution of intraventricular dromotropic disorders
2. What is the most probable cause(s) of these dromotropic disorders?
3. Is there a risk of sudden death?
4.What are the most appropriate approach steps?
