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Complete Atrioventricular Dissociation with Stokes-Adams Attacks Due to Disseminated Lupus Erythematosus
Report of a Case
- GEORGE R. MOFFITT, JR., M.D., F.A.C.P.
- Requests for reprints should be addressed to George R. Moffitt, Jr., M.D., Chief, Department of Medicine, Harrisburg Polyclinic Hospital, 2447 N. Third St. Harrisburg, Pa. 17110.
Excerpt
In most studies of disseminated lupus erythematosus over 50% of patients demonstrate some type of cardiac involvement. Thus Hejtmancik, Wright, Quint, and Jennings (1) found cardiac involvement in 58% of 142 cases. "Myocarditis" and pericarditis constitute the most frequently observed cardiac manifestations. Five cases of bundle branch block and one case of paroxysmal atrial tachycardia with atrioventricular block (considered due to digitalis toxicity) were reported by Hejtmancik and associates (1). Complete atrioventricular block with Stokes-Adams seizures has not been reported to have been caused by disseminated lupus erythematosus. Lev (2) does not include it as a cause of complete atrioventricular
Acknowledgments
Dr. Benjamin Musser inserted the artificial pacemaker; Dr. John Bray performed the second emergency cardiac catheterization during my absence. I am indebted to Miss Frances Goldsborough of the Art Department of the Harrisburg Hospital for the photographic reproduction of the electrocardiograms.
Summario in Interlingua
Un femina de 32 annos de etate—con bendocumentate disseminate lupus erythematose de quatro annos de duration, manifeste initialmente per polyserositis e subsequentemente per pericarditis—disveloppava attaccos de Stokes-Adams causate per un complete bloco cardiac. Un pacemaker-catheter esseva introducite. Isto, insimul con un augmento del medication de steroide, succedeva a restaurar le rhythmo sinusal. Tamen, un secunde e quasi mortal episodio que occurreva tres septimanas plus tarde rendeva necessari le implantation de un pacemaker artificial.
Un scrutinio del litteratura ha producite nulle altere caso de complete bloco atrioventricular con attaccos de Stokes-Adams causate per disseminate lupus erythematose. Disturbationes del conduction de branca es mentionate non infrequentemente in reportos concernite con manifestationes cardiovascular de disseminate lupus erythematose. Le constatationes electrocardiographic suggere bilateral bloco de branca como causa del dissociation atrioventricular in le presente caso.
Article and Author Information
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From the Department of Medicine, Harrisburg Polyclinic Hospital, Harrisburg, Pa.
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- Received May 12, 1965.
- Accepted June 25, 1965.
