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Hypertrophic cardiomyopathy presenting with 3rd-degree atrioventricular block
K L Rosen1, R W Cameron, P J Bigham
1Department of Pediatrics, Fitzsimons Army Medical Center, Aurora, Colorado 80045, USA.
Texas Heart Institute Journal
|January 1, 1997
Summary
A 15-year-old boy experienced exercise intolerance due to complete heart block. This rare presentation of hypertrophic cardiomyopathy highlights the importance of considering cardiac causes in pediatric patients.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Electrophysiology
Background:
- Hypertrophic cardiomyopathy (HCM) is a genetic heart muscle disease.
- Complete atrioventricular block is an uncommon complication of HCM, especially in pediatric cases.
- Exercise intolerance and syncope can be presenting symptoms.
Observation:
- A 15-year-old male presented with exercise intolerance and near syncope.
- Electrocardiography revealed third-degree atrioventricular block.
- Two-dimensional echocardiography diagnosed hypertrophic cardiomyopathy.
Findings:
- The patient required emergent temporary transvenous ventricular pacing.
- A permanent transvenous dual-chamber pacemaker was implanted.
- This case represents a rare instance where HCM presented primarily with complete atrioventricular block.
Implications:
- This case underscores the importance of considering cardiac causes, including HCM, in pediatric patients with syncope and heart block.
- Early diagnosis and management of HCM with AV block are crucial for preventing adverse outcomes.
- Further research into the mechanisms of AV block in HCM is warranted.