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The clinical course of acquired complete heart block in children with acute myocarditis

A S Batra1, D Epstein, M J Silka

  • 1Division of Cardiology, Riley Children's Hospital, Indiana University School of Medicine, Indianapolis, IN 46202, USA.

Pediatric Cardiology
|November 25, 2003
PubMed

Insights

Myocarditis in children can cause advanced atrioventricular (AV) block. Most young patients recover AV conduction within a week, but some require permanent pacemakers or face mortality.

Area of Science:

  • Pediatric Cardiology
  • Electrophysiology
  • Pediatric Infectious Diseases

Background:

  • Myocarditis, an inflammation of the heart muscle, can lead to serious cardiac complications in children.
  • Advanced atrioventricular (AV) block is a critical complication that affects cardiac conduction.
  • Understanding the prognosis of AV block in pediatric myocarditis is crucial for clinical management.

Observation:

  • A case of biopsy-proven myocarditis in a 7-year-old presented with advanced AV block.
  • A literature review identified 40 pediatric patients (age < 20 years) with myocarditis and AV block.
  • The study analyzed outcomes including recovery of AV conduction, need for pacing, and mortality.

Findings:

  • A significant majority of pediatric patients (67%) with myocarditis-associated AV block experienced recovery of AV conduction within 7 days.
  • Persistent AV block requiring permanent pacemaker implantation was observed in 28% of cases.
  • Mortality occurred in 5% of the studied pediatric population.

Implications:

  • Early identification and monitoring of AV block in pediatric myocarditis are essential.
  • The findings suggest a favorable prognosis for AV conduction recovery in most children.
  • A subset of patients will require long-term cardiac pacing, highlighting the need for careful follow-up.

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