Persistent Bradycardia in a Patient With Coronary Artery Disease and Concomitant Carotid Artery Disease

Authors

  • Adamantia Polydorou, et al Air Force Hospital & Evagelismos General Hospital, Athens

DOI:

https://doi.org/10.2015/hc.v5i1%20Sup.351

Abstract

We report a case of a 75-year-old male admitted to our hospital via the emergency room because of wide-QRS complex tachycardia. Non-ST elevation acute coronary syndrome (NSTE-ACS) was observed after termination of tachycardia. Coronary angiogram showed subtotal occlusion at the mid segment of the left anterior descending (LAD) coronary artery, which was treated by percutaneous transluminal coronary angioplasty (PTCA) and stenting. Because of persistent bradycardia (40-45 bpm) in the absence of β-blocker therapy, not responding to intravenous atropine, a temporary pacemaker was inserted. As the patient had bruits on auscultation of both carotid arteries, at the end of the coronary angioplasty procedure, carotid angiography was performed. This revealed severe bilateral disease which was treated with left internal carotid artery (LICA) angioplasty and stenting (CAS) performed at the same session, and right internal carotid artery (RICA) endarterectomy performed the day after. Interestingly, the bradycardia resolved a few hours post CAS. Before discharge, an electrophysiology study, undertaken to evaluate for the wide-QRS complex tachycardia and the persistent sinus bradycardia, yielded negative results. In conclusion, persistent bradycardia, in the absence of bradycardic agents, may be a clue to underlying carotid artery disease.

Author Biography

Adamantia Polydorou, et al, Air Force Hospital & Evagelismos General Hospital, Athens

Specialty: Cardiology

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Issue

Vol. 5 No. 1 Sup (2010)

Section

Athens Cardiology Update 2010

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