Reporting complete heart block in a patient with polyarteritis nodosa after COVID‐19 vaccination

Abstract

Complete heart block (CHB) is a serious health condition, and polyarteritis nodosa (PAN) is an important autoimmune disease. In the COVID‐19 pandemy, several vaccines were developed for the COVID‐19 disease that shown several side effects, and some of these complications are still unknown. This is the first report of CHB in a patient with history of PAN after COVID‐19 vaccination. A 68‐year‐old man with a history of PAN referred to our hospital, complaining of presyncope episodes and dizziness after receiving a COVID‐19 vaccine. Physical examination, laboratory tests, and transthoracic echocardiography were normal. In his electrocardiogram, a narrow QRS complex, AV dissociation, and junctional escape rhythm were seen. Coronary angiography showed a mild coronary artery disease. The patient, suffering from PAN for years, was hypothesized due to CHB a few days after COVID‐19 vaccination. This case report suggests that COVID‐19 vaccines may interrupt the conduction system of the heart and the fact that underlying PAN may predispose to CHB following COVID‐19 vaccination. Further studies are needed to accurately assess a possible association between PAN, CHB, and COVID‐19 vaccines.

Cardiac arrhythmia in COVID‐19 patients

“…Mobitz 2 is characterized by sporadically occurring blocks, without any Wenckebach phenomenon]), and complete heart block. Several studies have reported the incidence of persistent defects in the cardiac conduction system and the eventual need for a pacemaker in COVID‐19 patients (Mehrabinasab & Athari, 2022 , 2023 ). But Studies have shown that the most common bradyarrhythmias in COVID‐19 patients are severe sinus bradycardia and complete heart block (Gopinathannair et al., 2020 ).…”