My Father’s Heart Block

A daughter presents the case report

M. Kalaivani

Staff Nurse, Kauvery Speciality Hospital, Trichy, India

Case Presentation

My father, 53 years of age, with past history of Diabetes, but without hypertension, complained of giddiness for three days.

Clinical findings

On bringing him to Heart City, on arrival, he was conscious, oriented, with a heart rate of 30 beats per min. BP satisfactory.

ECG and Echo

ECG, on admission, indicated Third Degree Heart Block (Complete Heart Block), (Fig. 1).

My-Father-s-Heart-Block-1

Note bradycardia, rate 34, PP interval and RR interval constant, but no P and QRS correlation

Echo: Good LV function, Grade 1 diastolic dysfunction, concentric LVH, Aortic sclerosis

Electro physiology management

Temporary Pace Maker (TPI) was installed on day of admission.

Need for a dual chamber pacing permanent maker was discussed and agreed upon.

St Jude Medical- Endurity Core PM1 152 Pacemaker was installed., in mode ventricular demand pacing- VVI(R).

Procedure and post- operative period were uneventful

Post pacemaker ECGs (Figs. 2-4). Note vide QRS ventricular rhythms, and pacemaker spikes.

My-Father-s-Heart-Block-2
My-Father-s-Heart-Block-3
My-Father-s-Heart-Block-4

Outcome

On discharge: Asymptomatic. Pulse rate on discharge – 68/mt

Discussion:

The patient, my father, received the most appropriate care for his symptomatic Third-Degree Heart Block, with dual chamber pacing permanent maker in ventricular demand pacing- VVI(R)-mode.

My-Father-s-Heart-Block-5

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