Complete heart block in systemic sclerosis: A case report and literature review

RATIONALE: Complete heart block (CHB) is a common clinical manifestation. Systemic sclerosis (SSc) is a rare etiology of CHB that has not received enough attention. Whether pacemaker implantation is required remains inconclusive, especially when patients have no symptoms or mild symptoms of CHB. PATIENT CONCERNS: In this study, we report the case of a 48-year-old Chinese male who suffers from SSc and CHB. DIAGNOSE: The patient was previously diagnosed with left anterior hemiblock (LAHB) and right bundle block with normal heart function. CHB was observed on a regular follow-up electrocardiogram (ECG) examination 1 month before his hospitalization. INTERVENTIONS: A permanent dual chamber pacemaker was implanted. OUTCOMES: The patient responded well to pacemaker implantation treatment, and his exertional dyspnea disappeared. LESSONS: The occurrence of heart block associated with SSc often appears concealed. The case highlights the importance of regular follow-up of a patient with SSc. Pacemaker implantation might be unavoidable if CHB is secondary to SSc, even if it is asymptomatic.