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Vagally mediated intermittent high-grade atrioventricular block in an asymptomatic patient
  1. Sanjay Chandrasekhar1,2,
  2. Misbahuddin Syed3
  1. 1 Cardiology, University of South Florida College of Medicine, Tampa, Florida, USA
  2. 2 Cardiology, H Lee Moffitt Cancer Center and Research Center Inc, Tampa, Florida, USA
  3. 3 Internal and Hospital Medicine, Moffitt Cancer Center, Tampa, Florida, USA
  1. Correspondence to Dr Misbahuddin Syed, Internal and Hospital Medicine, Moffitt Cancer Center, Tampa, FL 33612, USA; Misbahuddin.Syed{at}

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A 71-year-old man with renal cell carcinoma presented to the hospital with worsening back pain. MRI of the spine demonstrated progressive metastasis with moderate cord compression at T2–T3 (figure 1A). The patient was promptly started on dexamethasone and radiation oncology was consulted. He developed cardiac rhythm changes on telemetry, and electrocardiography revealed a third-degree atrioventricular block (figure 1B). The patient remained asymptomatic and haemodynamically stable. Interestingly, the atrioventricular block was not seen with patient exertion, highlighting …

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  • Contributors SC and MS prepared the manuscript. MS formatted the submitted images and performed the submission process to the journal.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.