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Complete congenital heart block in a neonate with a complex congenital heart defect in Africa

Clovis Nkoke1, Edvine Yonta Wawo, Liliane Kuate Mfeukeu

  • 1Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon.

Cardiovascular Diagnosis and Therapy
|December 2, 2016
PubMed

Insights

Congenital heart block (CHB) is a rare disorder. This case highlights challenges in diagnosing and managing complex CHB in Sub-Saharan Africa, emphasizing antenatal screening.

Area of Science:

  • Cardiology
  • Pediatrics
  • Neonatology

Background:

  • Congenital heart block (CHB) is a rare condition, often with higher mortality when associated with structural congenital heart defects.
  • Cases of CHB are infrequently reported in Sub-Saharan Africa (SSA).

Observation:

  • A one-month-old neonate in Cameroon presented with bradycardia, mild cyanosis, and was diagnosed with complete CHB.
  • Obstetrical ultrasound during pregnancy had noted fetal bradycardia.
  • Clinical examination revealed bradycardia (62 bpm), mild cyanosis (SpO2 93%), with no signs of heart failure.

Findings:

  • Twelve-lead ECG showed complete atrioventricular conduction block, junctional escape rhythm (59/min), left axis deviation, and biventricular hypertrophy.
  • Two-dimensional echocardiography revealed complex congenital heart disease: dextrocardia, complete atrioventricular canal with a single atrium, mild atrioventricular valve regurgitation, and malposition of great vessels.

Implications:

  • This case underscores the diagnostic and management challenges of complex CHB in low-resource settings.
  • Enhanced antenatal care, including serial echocardiograms, can aid in early diagnosis and perinatal management for improved outcomes.
  • Highlights the clinical value of high-quality antenatal care and screening for congenital heart defects.

Keywords:
CameroonCongenital heart block (CHB)Sub-Saharan Africa (SSA)congenital heart defect

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