Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access
Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc
Journal website https://www.cardiologyres.org

Case Report

Volume 4, Number 1, February 2013, pages 35-40

Potential for Infra-Nodal Heart Block and Cardiogenic Shock With Propofol Administration

Figures

Figure 1.
Figure 1. Pre-operative ECG demonstrating RBBB, PR interval of 190, and QRS duration of 150 msec.
Figure 2.
Figure 2. Post implantation of a single lead VVI transvenous pacemaker demonstrating sinus tachycardia at 150 bpm, complete heart block, and ventricular demand pacing at 100 bpm.
Figure 3.
Figure 3. Day 5 ECG demonstrating a PR interval of 230 msec and a QRS duration of 150 msec with LBBB morphology.
Figure 4.
Figure 4. Day 5 ECG demonstrating PR interval of 190 msec and QRS duration of 150 msec with RBBB morphology and Mobitz type 2 AV block.
Figure 5.
Figure 5. Day 6 ECG demonstrating baseline RBBB, PR interval of 188 msec and QRS duration of 150 msec.

Table

Table 1. Hemodynamic Course
 
PresentationPost IABP**Post ImpellaPost A-V sequential pacer
* PCWP: Pulmonary Capillary Wedge Pressure; ** IABP: Intra-Aortic Balloon Pump.
Blood Pressure (mmHg)80/4070/90 Augmented90/70100/70
Atrial/Ventricualr Rate (beats/min)150/100 (paced)130/100 (paced)130/100 (paced)100/100 (paced)
PCWP* (mmHg)NA281815
Cardiac OutputNA2.0 L/min3.0 L/min4.8 L/min
Pressor DosagesDopamine 40 µg/kg/minDopamine 40 µg/kg/minDopamine 40 µg/kg/minLevophed 15µg/min
Levophed 20 µg/minLevophed 20 µg/minLevophed 20 µg/min