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Atrioventricular block complicating acute streptococcal tonsillitis.

J Caraco¹, R Arnon, I Raz

¹Department of Medicine B, Hadassah University Hospital, Jerusalem, Israel.

British Heart Journal

|March 1, 1988

Summary

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A woman with severe weakness and fever developed atrioventricular block and myocarditis due to Streptococcus haemolyticus group A infection. Prompt treatment led to recovery of normal heart rhythm.

Area of Science:

Cardiology
Infectious Diseases
Internal Medicine

Background:

Group A Streptococcus (GAS) pharyngitis can rarely lead to systemic complications.
Cardiac involvement in GAS infections, though uncommon, requires prompt recognition and management.

Observation:

A 38-year-old female presented with acute symptoms including severe weakness, high fever, and sore throat.
Physical examination revealed follicular tonsillitis and bradycardia attributed to atrioventricular block.

Findings:

The patient experienced transient ST-T wave changes indicative of myocarditis.
A throat culture confirmed the presence of Streptococcus haemolyticus group A.
Normal sinus rhythm was restored within 24 hours.

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Implications:

This case highlights the potential for severe cardiac manifestations, including atrioventricular block and myocarditis, secondary to GAS pharyngitis.
Early diagnosis and management are crucial for favorable outcomes in patients with GAS-associated cardiac complications.
Further research into the mechanisms and optimal treatment strategies for GAS-induced carditis is warranted.