Yasser's Wenckebach Reversal Phenomenon in a Caudate Nucleus Stroke, COVID-19 Pneumonia, Calculous Cholecystitis, and Ventricular Pacing-A new Cardiovascular Discovery and Interpretation

Rationale: Wenckebach phenomenon is a progressive prolongation of each successive PR interval and is mostly due to a reversible conduction block at the level of the AV node—Malfunctioning AV nodal cells. Caudate nucleus stroke presents with non-progressive symptoms, speech disturbances, chorea, and migraine. COVID-19 infection greatly varies from asymptomatic infection to severe pneumonia. Chronic cholecystitis is a chronic inflammation of the gallbladder resulting in mechanical or physiological dysfunction in its emptying. Ventricle pacing and sensing (VVI) involves ventricles instead of the atrium. If native ventricular activity is sensed then pacing is inhibited. Patient concerns: An elder housewife widow Egyptian female patient presented to the intensive care unit (ICU) with an acute right-side cerebrovascular accident, left-side deviation in the face, migraine, acute confusion, and COVID-19 pneumonia on top of diabetes, hypertension, chronic cholecystitis and ventricle pacing and sensing (VVI). Diagnosis: Yasser's Wenckebach reversal phenomenon in a caudate nucleus stroke, COVID-19 pneumonia, diabetes, hypertension, calculous cholecystitis, and ventricular pacing. Interventions: Chest CT scan, brain CT scan, electrocardiography, oxygenation, and Ventricle pacing. Outcomes: A clinical and electrocardiographic improvement occurred. Lessons Yasser's Wenckebach reversal phenomenon is a new cardiovascular discovery. A caudate nucleus stroke, COVID-19 pneumonia, calculous cholecystitis, and ventricular pacing are associated with the new phenomenon. The normalization of T-wave inversion in anterior leads is also parallel with the reversal of the progressive prolongation of each successive PR interval until a dropped beat from the left to the right. This will signify the Yasser's Wenckebach reversal phenomenon as a signal for the above normalization.