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Case Reports
. 2013 Jun;5(3):E90-2.
doi: 10.3978/j.issn.2072-1439.2013.05.06.

Atrioventricular nodal dysfunction secondary to hyperparathyroidism

Athanasios Vosnakidis  1 , Konstantinos Polymeropoulos, Paul Zarogoulidis, Ioannis Zarifis
Affiliations
Case Reports

Atrioventricular nodal dysfunction secondary to hyperparathyroidism

Athanasios Vosnakidis et al. J Thorac Dis. 2013 Jun.

Abstract

The relationship of hyperparathyroid-associated hypercalcemia with clinical significant bradyarrythmias still remains controversial. We present a 66-year-old patient with dizziness, headache and paroxysmal 2:1 atrioventricular block. A 24-hour Holter report revealed symptomatic intermittent 2(nd) degree (2:1) atrioventricular block with a mean heart rate of 46 bpm. A 2D echocardiogramm showed normal ejection fraction and there was no valve dysfunction or calcification. The biochemistry results showed elevated serum calcium level, low phosphate level, elevated serum parathyroid hormone level and normal serum levels of potassium, magnesium and sodium. The urine calcium excretion was 390 mg/24 h. A coronary angiography was performed and revealed no critical lesions. The patient continued to have symptoms despite of the treatment of hypercalcemia and a DDDR pacemaker was implanted. He had a Sestamibi-scan of the neck, that was suggestive of parathyroid adenoma, and parathyroidectomy was performed. The presuming mechanism is the degeneration of AV node due to calcium deposit.

Keywords: Atrioventricular nodal dysfunction; hypercalcemia; hyperparathyroidism (HPT).

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References

    1. Ariyan CE, Sosa JA. Assessment and management of patients with abnormal calcium. Crit Care Med 2004;32:S146-54 - PubMed
    1. Seely EW, Williams GH. The heart in endocrine disorders. In: Braunwald. eds. Heart Disease (6th Edition). Philadelphia: WB Saunders. 2001:2166.
    1. Vardas PE, Auricchio A, Blanc JJ, et al. Guidelines for cardiac pacing and cardiac resynchronization therapy: The Task Force for Cardiac Pacing and Cardiac Resynchronization Therapy of the European Society of Cardiology. Developed in collaboration with the European Heart Rhythm Association. Eur Heart J 2007;28:2256-95 - PubMed
    1. Pilz S, Tomaschitz A, Drechsler C, et al. Parathyroid hormone level is associated with mortality and cardiovascular events in patients undergoing coronary angiography. Eur Heart J 2010;31:1591-8 - PubMed
    1. Birgander M, Bondeson A, Bondeson L, et al. Relationship between mild primary hyperparathyroidism and left ventricular structure and diastolic performance. Endocrinologist 2009;19:187-91

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