Third-degree atrioventricular block, commonly referred to as complete heart block, is a condition characterized by a disruption in the electrical conduction of the heart leading to significant circulatory compromise. While often asymptomatic, it can present acutely, especially under stress or with certain medications. Anesthetic agents, with their potential to depress cardiac function, can unmask underlying cardiac conduction abnormalities in susceptible individuals. This case report highlights the importance of thorough preoperative assessment, even for seemingly low-risk procedures, to identify potential complications and optimize patient care.

 

This case of unmasked complete heart block is unique due to the patient’s complex medical history and rapidness of detection after induction agents were administered. Despite the initial challenges, the patient received timely intervention with pacemaker implantation, resulting in a favorable outcome. The rhythm conversion from sinus bradycardia to complete heart block can appear subtly on the monitor and carry a profound impact on overall patient outcome.