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Complete atrioventricular block following myocarditis in children
1Institute of Clinical Medicine and Department of Pediatrics, National Cheng Kung University Hospital, No. 138, Sheng Li Road, Tainan 70428, Taiwan.
Pediatric Cardiology
|August 22, 2002
Summary
Acquired complete atrioventricular block (CAVB) in children due to infectious myocarditis is serious but treatable. Early diagnosis and management lead to good long-term outcomes, with most patients recovering fully.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Electrophysiology
Background:
- Complete atrioventricular block (CAVB) in children can be congenital or acquired.
- Acquired CAVB is sometimes associated with myocarditis.
Observation:
- This study reviewed nine children with acquired, non-surgical CAVB due to suspected infectious myocarditis.
- Patients presented with CAVB, wide QRS escape rhythm, congestive heart failure, and some with ventricular tachycardia or Stokes-Adams seizures.
- Seven children had a preceding upper respiratory tract infection.
Findings:
- Infectious myocarditis was the suspected cause of CAVB in these pediatric patients.
- All patients received inotropic agents and temporary pacing; most recovered sinus rhythm within 10 days.
- Long-term follow-up (9-96 months) showed all patients were asymptomatic and drug-free, with most having normal or improved ECGs.
Implications:
- CAVB secondary to myocarditis in children, though potentially life-threatening, has a favorable prognosis with prompt diagnosis and intervention.
- Early management is crucial for preventing long-term sequelae in pediatric patients with infectious myocarditis-induced CAVB.