Infective Endocarditis Presenting with Complete Atrioventricular Block in the Emergency Department

感染性心內膜患者在急診室以完全性房室傳導阻滯表現

陳守彥(Shou-Yen Chen)；詹逸凌(Yi-Ling Chan)；賀萬靖(Wan-Jing Ho)；陳日昌(Jih-Chang Chen)；張玉喆(Yu-Che Chang)

心內膜炎 ； 房室傳導障礙 ； endocarditis ； atrioventricular block

Journal of Emergency Medicine, Taiwan

13卷1期（2011 / 03 / 01）

29 - 32

英文

感染性心內膜炎易造成許多併發症，其中較少出現的是傳導異常。當感染於瓣膜形成膿瘍而影響傳導系統時便可能出現各種心律不整的現象，特別是當影響主動脈瓣時更容易產生此類現象。當心內膜炎同時伴隨傳導異常及心律不整時，代表感染範圍較大且可能已經形成膿瘍。對於此類病人來說，及時手術治療通常能有較好的預後。因此我們在此分享一個在急診以新發生的房室傳導異常表現的心內膜炎病例，藉以提醒大家注意此種心內膜炎可能的表現。

Endocarditis has been associated with conduction abnormalities because the infection potentially spreads through the septum and affects the conduction system. Aortic valve involvement commonly leads to this complication. Conduction abnormality induced by endocarditis often indicates extensive infection with possible abscess formation and has been demonstrated to be related to high mortality. Urgent surgical treatment is mandatory for better outcome. We presented a patient of endocarditis with a new atrioventricular block to alert physicians this rare but fatal etiology of conduction abnormalities.