Abstract
Two cases are described, one of cardiac sarcoidosis and another of primary cardiac amyloidosis, in which correlation was made between electrophysiologic and postmortem conduction system studies. In Case 1 the electrocardiogram revealed right bundle branch block with first degree and intermittent third degree atrioventricular (A-V) block and recurrent unifocal paroxysmal ventricular tachycardia. Electrophysiologic studies disclosed normal sinus rhythm with prolonged A-H (175 ms) and H-V (60 ms) intervals and extrastimulus induction of repetitive ventricular firing. Postmortem examination revealed a sarcoid aneurysm of the posterior left ventricle and granulomatous infiltration of the A-V node, His bundle and bundle branches. In Case 2 the electrocardiogram revealed sinus bradycardia, a prolonged S-T interval and recurrent ventricular fibrillation. Electrophysiologic studies demonstrated a prolonged sinus nodal recovery time (6,080 ms) and H-V (85 ms) interval. Postmortem examination revealed marked amyloid infiltration of the sinoatrial node, atria, proximal bundle branches and left and right ventricular myocardium. There was thus excellent correlation between electrophysiologic and pathologic findings. These cases indicate the importance of making a clinical diagnosis of the disease that might in some cases allow specific therapeutic intervention in addition to antiarrhythmic therapy.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 163-173 |
| Number of pages | 11 |
| Journal | The American journal of cardiology |
| Volume | 45 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 1980 |
Funding
From the Congenital Heart Disease Research and Training Center, Hektoen Institute for Medical Research, Chicago, Illinois; the Department of Pathology, Northwestern University Medical School; Pritzker School of Medicine, University of Chicago; The Chicago Medical School, University of Health Sciences; Loyola University, Stritch School of Medicine; the Section of Cardi- olo~y, Department of Medicine and the Department of Pathology, Abraham Lincoln School of Medicine, Universitv of Illinois: and the Deoart-ments of Pediatrics, Medicine and Pathology, Bush Medical College, Chicago, Illinois. This study was aided by Grants HL 0760516, HL 07387-01, HL 18794 and HL 23586-01 from the National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, Maryland. Manuscript received June 4, 1979, accepted August 17, 1979. * Career Investigator and Educator, Chicago Heart Association, Chicago, Illinois.
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine