When the brain slows the heart—herpes encephalitis and sinus arrest: a case report
Abstract Background Herpes simplex virus (HSV) encephalitis is a known cause of cognitive deterioration, neurological disturbances, and seizures though are rarely associated with sinus node dysfunction. Case summary We present a 54-year-old man admitted to the hospital with a 10-day history of fever...
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Published in | European heart journal : case reports Vol. 5; no. 8 |
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Main Authors | , , |
Format | Journal Article |
Language | English |
Published |
Oxford University Press
01.08.2021
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Subjects | |
Online Access | Get full text |
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Summary: | Abstract
Background
Herpes simplex virus (HSV) encephalitis is a known cause of cognitive deterioration, neurological disturbances, and seizures though are rarely associated with sinus node dysfunction.
Case summary
We present a 54-year-old man admitted to the hospital with a 10-day history of fever, confusion, and fatigue, 1 week following a transient loss of consciousness. An initial workup suggested HSV encephalitis and the patient was started on intravenous Acyclovir. Due to his episode of syncope, a 24 h Holter electrocardiogram monitoring was performed. The Holter documented multiple episodes of sinus arrest, with a second episode of syncope noticed by the hospital staff concurrent with the last documented sinus arrest. Following antiviral treatment and resolution of the encephalitis we noticed complete resolution of sinus node dysfunction. We subsequently avoided permanent pacemaker implantation.
Discussion
Our case of proven HSV encephalitis complicated by sinus node arrest and syncope with complete resolution following antiviral treatment suggests no indication for permanent pacemaker implantation. This approach is consistent with data from previously reported cases. |
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ISSN: | 2514-2119 2514-2119 |
DOI: | 10.1093/ehjcr/ytab254 |