Heart Block in Pregnancy From Parvovirus B19

Complete heart block is a rare and possibly life-threatening condition in pregnancy, requiring timely recognition and multispecialty management.

This case report describes a previously healthy pregnant woman who developed high-grade atrioventricular block due to a parvovirus B19 infection. Before her presentation, she had a upper respiratory infection with a "slapped cheek" rash, classic for parvovirus B19. Other cardiac, infectious, and rheumatologic etiologies were excluded. She had subsequent recovery of atrioventricular conduction with conservative management.

Although congenital heart block is a known fetal complication of parvovirus B19, maternal cardiac conduction abnormalities linked to this virus have not previously been documented. Patients with heart block during pregnancy should be managed similarly to those who are not pregnant; however, caution should be exercised when using fluoroscopy for pacemaker placement.

This case highlights the importance of a broad differential diagnosis, a multidisciplinary approach, and appropriate maternal-fetal risk stratification in the management of cardiac arrhythmias during pregnancy.