Lev's Syndrome: A rare case of progressive cardiac conduction disorder presenting to the emergency department

Brandon M. Carius, Brit Long, Steve Schauer

Research output: Contribution to journalArticlepeer-review

Abstract

Lev's Syndrome is a rare, progressive cardiac conduction defect (PCCD) due to myocardial fibrosis first described by Maurice Lev in 1964. This condition, proposed to start in the fourth decade of life, involves a sclerotic fibro-fatty degeneration of the Bundle of His and Purkinje fibers, which Lev proposed caused increasing AV delay with age. With the prevalence of electrocardiogram (ECG) use in the emergency department (ED) for cardiac- and non-cardiac complaints, dysrhythmias can be incidentally found and confuse diagnosis and disposition. We highlight the case of an 84-year-old male who presented to the ED for acute onset of diffuse facial paresthesias with elevated blood pressure at home and was found to be significantly bradycardic on initial evaluation. On serial ECGs, the conduction rhythm changed from an initial new first-degree atrioventricular (AV) block with left bundle branch block (LBBB), to a later first-degree AV block without LBBB. Cardiology was consulted. Serial ECGs demonstrated an evolving conduction block arrhythmia consistent with Lev's Syndrome. Here we describe a case of symptomatic bradycardia found to be consistent with Lev's Syndrome.

Original languageEnglish (US)
Pages (from-to)1006.e1-1006.e4
JournalAmerican Journal of Emergency Medicine
Volume37
Issue number5
DOIs
StatePublished - May 2019
Externally publishedYes

Keywords

  • Cardiac dysfunction
  • Dysrhythmia
  • Lev's Syndrome

ASJC Scopus subject areas

  • Emergency Medicine

Fingerprint Dive into the research topics of 'Lev's Syndrome: A rare case of progressive cardiac conduction disorder presenting to the emergency department'. Together they form a unique fingerprint.

Cite this