A rare form of trifascicular block with intermittent complete atrioventricular block in a patient with Chagas disease. 2009

Francisco Femenia, and Alejandro Cuesta, and Arce Mauricio
Unidad de Arritmias, Departamento de Cardiología, Hospital Espanol de Mendoza, Argentina. femeniafavier@hotmail.com

Trifascicular block, which consists of impaired conduction in the three main fascicles of the ventricular conduction system, may progress to high-grade or complete atrioventricular block. Exceptionally, it is possible to register in the same patient paroxysmal alternating atrioventricular block and bilateral bundle branch block. This is the electrocardiogram of a male, 60 year-old patient coming from an endemic area, with positive serology for Chagas disease, with the exclusively dromotropic form (there are no signs of cardiac muscle involvement), manifest by repetitive pre-syncope and syncope episodes.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D002037 Bundle-Branch Block A form of heart block in which the electrical stimulation of HEART VENTRICLES is interrupted at either one of the branches of BUNDLE OF HIS thus preventing the simultaneous depolarization of the two ventricles. Fascicular Block,Anterior Fascicular Block,Bundle Branch Block,Left Bundle-Branch Block,Posterior Fascicular Block,Right Bundle-Branch Block,Anterior Fascicular Blocks,Block, Anterior Fascicular,Block, Bundle Branch,Block, Bundle-Branch,Block, Fascicular,Block, Left Bundle-Branch,Block, Posterior Fascicular,Block, Right Bundle-Branch,Blocks, Anterior Fascicular,Blocks, Bundle Branch,Blocks, Bundle-Branch,Blocks, Fascicular,Blocks, Left Bundle-Branch,Blocks, Posterior Fascicular,Blocks, Right Bundle-Branch,Branch Block, Bundle,Branch Blocks, Bundle,Bundle Branch Blocks,Bundle-Branch Block, Left,Bundle-Branch Block, Right,Bundle-Branch Blocks,Bundle-Branch Blocks, Left,Bundle-Branch Blocks, Right,Fascicular Block, Anterior,Fascicular Block, Posterior,Fascicular Blocks,Fascicular Blocks, Anterior,Fascicular Blocks, Posterior,Left Bundle Branch Block,Left Bundle-Branch Blocks,Posterior Fascicular Blocks,Right Bundle Branch Block,Right Bundle-Branch Blocks
D006329 Heart Conduction System An impulse-conducting system composed of modified cardiac muscle, having the power of spontaneous rhythmicity and conduction more highly developed than the rest of the heart. Conduction System, Heart,Conduction Systems, Heart,Heart Conduction Systems,System, Heart Conduction,Systems, Heart Conduction
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013575 Syncope A transient loss of consciousness and postural tone caused by diminished blood flow to the brain (i.e., BRAIN ISCHEMIA). Presyncope refers to the sensation of lightheadedness and loss of strength that precedes a syncopal event or accompanies an incomplete syncope. (From Adams et al., Principles of Neurology, 6th ed, pp367-9) Drop Attack,Fainting,Presyncope,Syncope, Postural,Syncopal Episode,Syncopal Vertigo,Syncope, Cardiogenic,Syncope, Carotid Sinus,Syncope, Convulsive,Syncope, Deglutitional,Syncope, Effort,Syncope, Hyperventilation,Syncope, Micturition,Syncope, Situational,Syncope, Stokes-Adams,Syncope, Tussive,Attack, Drop,Cardiogenic Syncope,Cardiogenic Syncopes,Carotid Sinus Syncope,Carotid Sinus Syncopes,Convulsive Syncope,Convulsive Syncopes,Deglutitional Syncope,Deglutitional Syncopes,Drop Attacks,Effort Syncope,Effort Syncopes,Episode, Syncopal,Hyperventilation Syncope,Hyperventilation Syncopes,Micturition Syncope,Micturition Syncopes,Postural Syncope,Postural Syncopes,Presyncopes,Situational Syncope,Situational Syncopes,Stokes-Adams Syncope,Stokes-Adams Syncopes,Syncopal Episodes,Syncope, Stokes Adams,Syncopes,Syncopes, Cardiogenic,Syncopes, Carotid Sinus,Syncopes, Convulsive,Syncopes, Deglutitional,Syncopes, Effort,Syncopes, Hyperventilation,Syncopes, Micturition,Syncopes, Postural,Syncopes, Situational,Syncopes, Stokes-Adams,Syncopes, Tussive,Tussive Syncope,Tussive Syncopes,Vertigo, Syncopal,Vertigos, Syncopal
D014355 Chagas Disease Infection with the protozoan parasite TRYPANOSOMA CRUZI, a form of TRYPANOSOMIASIS endemic in Central and South America. It is named after the Brazilian physician Carlos Chagas, who discovered the parasite. Infection by the parasite (positive serologic result only) is distinguished from the clinical manifestations that develop years later, such as destruction of PARASYMPATHETIC GANGLIA; CHAGAS CARDIOMYOPATHY; and dysfunction of the ESOPHAGUS or COLON. Trypanosomiasis, South American,American Trypanosomiasis,Chagas' Disease,Trypanosoma cruzi Infection,Infection, Trypanosoma cruzi,Infections, Trypanosoma cruzi,South American Trypanosomiasis,Trypanosoma cruzi Infections,Trypanosomiasis, American
D015716 Electrocardiography, Ambulatory Method in which prolonged electrocardiographic recordings are made on a portable tape recorder (Holter-type system) or solid-state device ("real-time" system), while the patient undergoes normal daily activities. It is useful in the diagnosis and management of intermittent cardiac arrhythmias and transient myocardial ischemia. Ambulatory Electrocardiography,Electrocardiography, Dynamic,Electrocardiography, Holter,Holter ECG,Holter EKG,Holter Monitoring,Monitoring, Ambulatory Electrocardiographic,Monitoring, Holter,Ambulatory Electrocardiography Monitoring,Dynamic Electrocardiography,Electrocardiography Monitoring, Ambulatory,Holter Electrocardiography,Ambulatory Electrocardiographic Monitoring,ECG, Holter,ECGs, Holter,EKG, Holter,EKGs, Holter,Electrocardiographic Monitoring, Ambulatory,Holter ECGs,Holter EKGs,Monitoring, Ambulatory Electrocardiography
D054537 Atrioventricular Block Impaired impulse conduction from HEART ATRIA to HEART VENTRICLES. AV block can mean delayed or completely blocked impulse conduction. AV Block,Atrioventricular Conduction Block,AV Blocks,Atrioventricular Blocks,Atrioventricular Conduction Blocks,Block, AV,Blocks, AV,Conduction Block, Atrioventricular,Conduction Blocks, Atrioventricular

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