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Case Report

Open Access

Intermittent Complete Heart Block in Acute Calculous Cholecystitis

  • MAŠA SORIĆ1
  • WILMA MILETIĆ1
  • SEAD ŽIGA1
  • VLATKO GRABOVAC1

1Department of Emergency Medicine, University Hospital Dubrava, Zagreb, Croatia

DOI: 10.22514/SV101.062015.14 Vol.10,Issue S1,June 2015 pp.53-54

Published: 22 June 2015

*Corresponding Author(s): MAŠA SORIĆ E-mail: masa.soric@kbd.hr

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Abstract

The aim of this case report is to present a case of a 24-year old male patient with known cholelithiasis who was presented to the emergency department with acute calculous cholecystitis. The patient was in-itially in sinus rhythm, but during observa-tion converted into a complete heart block. A temporary heart pacemaker was in-serted prior to an emergency laparoscopic cholecystectomy. Postoperatively, the pa-tient converted back to sinus rhythm and made a complete recovery. Considering the patient’s age, normal cardiac workup and that his arrhythmia disappeared after the removal of his gallbladder, it was pos-tulated that this patient had a case of car-dio-biliary reflex. Special attention must be given to patients with acute cholecystitis and electrocardiographic changes. Acute cholecystitis is a treatable cause of a newly diagnosed atrioventricular block, thus im-mediate cholecystectomy should not be deferred.

Key words

Atrioventricular block, cholecys-titis, gallstones, cardio-biliary reflex

Cite And Share

MAŠA SORIĆ,WILMA MILETIĆ,SEAD ŽIGA,VLATKO GRABOVAC. Intermittent Complete Heart Block in Acute Calculous Cholecystitis. Signa Vitae. 2015. 10(S1);53-54.

References

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3. Hayden GE, Brady WJ, Pollack M, Harrigan RA. Electrocardiographic manifestations: Diagnosis of atrioventricular block in the emer-gency department. J Emerg Med. 2004;26:95–106.

4. O’Reilly MV, Krauthamer MJ. “Cope’s sign” and reflex bradycardia in two patients with cholecystitis. Br Med J. 1971;2:14.

5. Krasna MJ, Flancbaum L. Electrocardiographic changes in cardiac patients with acute gallbladder disease. Am Surg. 1986;52:541-3.

6. Franzen D, Jung S, Fatio R, Brunckhorst CB. Complete atrioventricular block in a patient with acute cholecystitis: a case of cardio-biliary reflex? Eur J Emerg Med 2009;16:346-7.

7. Lau YM, Hui WM, Lau CP. Asystole complicating acalculous cholecystitis, the “Cope’s sign” revisited. Int J Cardiol. 2015;182:447-8.

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