Transient Complete Heart Block Following Isolated Severe Traumatic Brain Injury: A Rare Brain–Heart Interaction

Cardiac complications occur in 40 to 50% of patients with traumatic brain injury (TBI) and are associated with increased morbidity and mortality. 1,2 Although often reversible, the severity and duration of cardiac dysfunction can signi fi cantly in fl uence clinical outcomes. Cardiac manifestations range from benign abnormalities to life-threatening arrhythmias including severe bradycardia, supraventricular tachycardia, QT interval prolongation, regional wall motion abnormalities, elevated cardiac biomarkers, myocardial stunning, and stress-induced cardiomyopathy (Takotsubo syndrome). Complete heart block (CHB), however, is rarely reported, and its true incidence remains poorly de fi ned. 3,4 We report a case of severe TBI associated with CHB. A 51-year-old male presented to the emergency department within an hour of a road traf fi c accident, with loss of consciousness and epistaxis. On primary survey, Glasgow Coma Scale was E 1 V 1 M 5 . The airway was secured and mechanical ventilation was initiated. Postresuscitation vitals were stable,