Complete atrioventricular block after an anesthetic induction in a patient with unknown metabolic acidosis

L. Ferreira; P. Santos; F. Correia; A. Vieira; A. Bernardino; A. Freitas

doi:10.35975/apic.v26i2.1828

L. Ferreira
P. Santos
F. Correia
A. Vieira
A. Bernardino
A. Freitas

DOI: https://doi.org/10.35975/apic.v26i2.1828

Keywords: Atrioventricular block, General anesthesia, Metabolic acidosis, Bradycardia

Abstract

Clinical case of an 84-year-old female patient who developed a complete heart block a few minutes after anesthetic induction associated with hemodynamic instability, nonresponsive to vagolytic and adrenergic medication. Transcutaneous pacing was started with hemodynamic improvement. After the event, a decompensated metabolic acidosis was detected which was promptly corrected, leading to a normalization of the heart rhythm. Metabolic acidosis is a described but uncommon cause of atrioventricular block. The authors are not aware of previous report of complete heart block in this context. We would like to draw attention to the importance of choosing carefully which anesthetic drugs should be used in these cases.

Key words: Atrioventricular block; General anesthesia; Metabolic acidosis; Bradycardia

Citation: Ferreira LS, Santos P, Correia F, Vieira A, Freitas A. Complete atrioventricular block after an anesthetic induction in a patient with unknown metabolic acidosis. . Anaesth. pain intensive care 2022;26(2): ; DOI: 10.35975/apic.v26i2.1828

Received: December 18, 2021, Reviewed: January 27, 2022, Accepted: February 2, 2022