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Course: Diagnostic Challenges in Atrioventricular Block Preceding Cardiomyopathy

CME Credits: 1.00

Released: 2023-10-09

A patient in their 30s without any previous medical and family history presented to the emergency department because of palpitations for 14 hours. The patient reported no chest pain, shortness of breath, vertigo, or dizziness. The vital signs on admission included a temperature of 36.8 °C, blood pressure of 102/57 mm Hg, pulse rate of 170 beats/min, and respiratory rate of 20 breaths/min. Results of the physical examination were normal except for fast heart rate. Subsequent investigation revealed a troponin T level of 0.018 ng/mL (reference range, <0.014 ng/mL; to convert to µg/L, multiply by 1.0) and an N-terminal pro–brain-type natriuretic peptide level of 1709 pg/mL (reference range, <125 pg/mL; to convert to ng/L, multiply by 1.0). Echocardiography at sinus rhythm showed a mild enlarged left atrium (diameter, 34 mm) and a normal left ventricle (end-diastolic diameter, 46 mm; ejection fraction, 72%). The 12-lead electrocardiogram (ECG) on admission is shown in the , A.


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