Syncope in a middle aged male due to acute rheumatic fever

Area of Science:

• Cardiology
• Rheumatology
• Infectious Diseases

Background:

• Rheumatic fever is a multisystem inflammatory disease following group A beta-hemolytic streptococcus infection.
• While common in children (5-15 years), rheumatic fever can affect adults.
• First-degree atrioventricular block is a recognized Jones criterion, but advanced blocks are rare.

Observation:

• This report details a rare case of rheumatic carditis in a 38-year-old male.
• The patient presented with advanced atrioventricular block, a rare manifestation of rheumatic fever.
• Syncope, an infrequent symptom, occurred due to the severe heart block.

Findings:

• The case demonstrates advanced atrioventricular block in an adult with rheumatic carditis.
• Syncope was a direct consequence of the cardiac conduction abnormality.
• Temporary pacemaker insertion was required to manage the life-threatening arrhythmia.

Implications:

• Highlights the potential for severe cardiac manifestations of rheumatic fever in adults.
• Underscores the importance of considering rheumatic fever in adult patients with unexplained heart block and syncope.
• Suggests the need for vigilance in diagnosing and managing rheumatic carditis, even in atypical patient demographics.