Consumption of large quantities of alcohol has a number of well-known consequences, but the effect endured by one patient is rather remote. A 27-year-old black man was brought to the emergency department after suffering head trauma that initially left him unconscious. His score on the Glasgow Coma Scale was 14, denoting a mild head injury. Physical examination on admission revealed that the patient had a monocular hematoma. Computed tomography excluded intracranial bleeding and other serious injuries. Laboratory values revealed an increased serum alcohol concentration of 6.3 g/L, indicating acute alcohol intoxication. A urine screen for illicit drugs was negative. The patient was not on any regular medication.
An electrocardiogram (ECG) showed a sinus rhythm with a heart rate of 84 beats per minute, a first-degree atrioventricular block, and a prolonged PR interval of 338 ms (Figure 1). Furthermore, nonspecific ST-segment elevations were noted in leads II, III, and aVF, a pattern compatible with benign early repolarization. Both the QRS interval and the QT interval, corrected for heart rate, were within normal ranges…
Atrioventricular block induced by alcohol consumption is very rarely reported. Although this is a transient phenomenon, the patient’s heart rhythm must be monitored to exclude high-degree atrioventricular block. Intoxication might aggravate the conduction delay in patients with preexisting atrioventricular-nodal disease, thus triggering high-degree atrioventricular block, but at present, there are no published data to substantiate this hypothesis.
To read this article in its entirety, please visit our website.
– Jelena R. Ghadri, MDemail address, Christian Templin, MD, PhD, Firat Duru, MD, Thomas F. Lüscher, MD, Laurent M. Haegeli, MD
This article originally appeared in the September 2013 issue of The American Journal of Medicine.
