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Advanced atrioventricular conduction block in acute rheumatic fever
Eli Zalzstein1, Rachel Maor, Nili Zucker
1Pediatric Cardiology Unit, Department of Cardiology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. eliz@bgumail.bgu.ac.il
Cardiology in the Young
|February 26, 2004
Summary
Advanced atrioventricular block during acute rheumatic fever is rare and typically temporary. Most cases resolve with anti-inflammatory treatment, with pacemakers only considered for persistent symptoms.
Area of Science:
- Cardiology
- Pediatrics
- Rheumatology
Background:
- Acute rheumatic fever can cause cardiac complications, including atrioventricular conduction abnormalities.
- Understanding the incidence and management of these blocks is crucial for pediatric cardiac care.
Purpose of the Study:
- To evaluate the outcomes and treatment needs for atrioventricular conduction problems during acute rheumatic fever.
- To assess the occurrence of second- and third-degree atrioventricular block compared to first-degree block.
Main Methods:
- Retrospective case-control analysis of 65 children with acute rheumatic fever.
- Review of clinical, electrocardiographic, and echocardiographic records from 1994-2001.
- Assessment of atrioventricular block degrees and treatment interventions.
Main Results:
- First-degree atrioventricular block occurred in 72.3% and resolved with anti-inflammatory medication.
- Advanced blocks (second- and third-degree) were rare (1.5% and 4.6%, respectively).
- All advanced blocks resolved with conventional treatment, with no need for pacemakers in this cohort.
Conclusions:
- Advanced atrioventricular block is uncommon in acute rheumatic fever.
- Conduction disturbances are generally temporary and resolve with anti-inflammatory therapy.
- Pacemaker insertion is reserved for cases with persistent syncope or clinical symptoms.