Slow The Pace: Bradycardia In Cyclist

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Slow The Pace: Bradycardia In Cyclist - Page #3

Lab Studies: An EKG was obtained which showed a heart rate of 40, complete heart block, left axis deviation, QtC 414; QRS 150 and no ST segment elevation/depression or T wave inversions in lead II, III, or aVF Case Photo #2 . Complete blood count and comprehensive metabolic panel were unremarkable. Troponin was negative. Other Studies: A cardiac MRI was obtained which showed the following: Left ventricle was mildly dilated with mild global systolic dysfunction. Left ventricular ejection fraction was 45%. There was mid-wall delayed enhancement involving the anterior septum, findings which, though not characteristic for cardiac sarcoidosis, were consistent with non-ischemic cardiomyopathy. Consultations: After the initial presentation to the primary care office, the patient was transferred to the emergency department for cardiac consultation. Given his asymptomatic state, arrangements were made for an outpatient electrophysiology appointment. He underwent placement of a dual chamber pacemaker 10 days from his initial presentation to the primary care clinic. Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.		Back
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