EAS Publisher | High-Degree Atrioventricular Block as an Initial Presentation of Interventricular Septal Abscess: A Case Report from the Abidjan Heart Institute

High-Degree Atrioventricular Block as an Initial Presentation of Interventricular Septal Abscess: A Case Report from the Abidjan Heart Institute

DOI : https://doi.org/10.36349/easjms.2026.v08i01.008

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High-degree atrioventricular (AV) block is a life-threatening emergency that may reveal an underlying infectious cause, such as a septal interventricular abscess. We report a case of a 22-year-old male admitted with recurrent syncopal episodes. Clinical evaluation revealed irregular bradycardia (42 bpm) and a grade 3/6 diastolic murmur at the aortic area. Electrocardiography confirmed high-degree AV block, necessitating temporary pacing. Multimodal imaging including transthoracic, transesophageal echocardiography and cardiac Computed Tomography identified an abscess-like collection within the interventricular septum, originating from the aortic valve. Laboratory findings supported systemic infection. Due to limited surgical capacity, the patient was managed conservatively with antibiotic therapy. He demonstrated clinical improvement, with regression of the abscess and resolution of conduction abnormalities to first-degree AV block, allowing removal of the temporary pacemaker. This case highlights the severity of infectious AV block and illustrates the diagnostic and therapeutic challenges faced in resource-limited settings.

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