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Complete atrioventricular block in an adolescent with rheumatic Fever
1Department of Pediatrics, College of Medicine, Soonchunhyang University, Cheonan, Korea.
Korean Circulation Journal
|December 2, 2009
Summary
Rheumatic fever can rarely cause complete heart block in children. This case shows that heart block associated with rheumatic fever can resolve with prompt treatment and anti-inflammatory medication.
Area of Science:
- Pediatrics
- Cardiology
- Rheumatology
Background:
- Rheumatic fever is an inflammatory condition following group A streptococcal infection.
- Major diagnostic criteria include polyarthritis, carditis, chorea, subcutaneous nodules, and erythema marginatum.
- Advanced heart block is a rare but serious complication.
Purpose of the Study:
- To report a case of complete atrioventricular block in a pediatric patient with rheumatic fever.
- To highlight the resolution of heart block with non-cardiac specific treatment.
Main Methods:
- Case report of a 13-year-old boy presenting with exertional dyspnea.
- Diagnosis of rheumatic fever based on clinical findings, elevated acute phase reactants, and high antistreptolysin O titer.
- Treatment included benzathine penicillin and salicylate therapy.
Main Results:
- The patient presented with complete atrioventricular block.
- Following treatment, electrocardiogram showed resolution to 1st-degree atrioventricular block within 5 days.
- Electrocardiogram normalized after discharge with continued penicillin prophylaxis.
Conclusions:
- Complete atrioventricular block can be a rare manifestation of rheumatic fever.
- Prompt diagnosis and treatment of rheumatic fever are crucial.
- Heart block in this context may resolve without specific cardiac interventions beyond anti-inflammatory management.
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