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Cerebral infarction in a patient with congenital complete heart block
Y Hayabuchi1, S Matsuoka, M Nii
1Department of Pediatrics, Tokushima University School of Medicine, Japan.
Insights
Stokes-Adams attacks are common in children with congenital complete heart block, but cerebral infarction is rare. This case highlights a 13-year-old boy experiencing an embolic stroke, likely due to bradycardia.
Area of Science:
- Pediatric Cardiology
- Neurology
- Clinical Case Reports
Background:
- Congenital complete heart block (CCHB) can lead to Stokes-Adams attacks in children.
- Cerebral infarction is an uncommon complication of CCHB.
Observation:
- A 13-year-old boy with CCHB presented with an embolic stroke affecting a cerebral artery.
- Echocardiography excluded cardiac sources like valvular issues, thrombi, or myxomas.
- ECG monitoring showed exercise-responsive heart rate but no significant arrhythmias.
Findings:
- The patient experienced an embolic stroke, a rare event in pediatric CCHB.
- Bradycardia, a characteristic of CCHB, is hypothesized as the cause of embolism.
Implications:
- This case underscores the potential for unusual neurological complications in CCHB.
- It emphasizes the need for vigilance regarding embolic events, even without typical cardiac risk factors.
- Further research may explore the link between bradycardia and embolic phenomena in pediatric heart block.
Abstract:
Stokes-Adams attacks are fairly common in children with congenital complete heart block, but the occurrence of cerebral infarction is quite unusual. We present the case of a 13-year-old boy with congenital heart block and an embolic stroke involving the cerebral artery. Echocardiography revealed no valvular regurgitation, hypokinetic segments, mural thrombus, or myxoma. Electrocardiographic monitoring demonstrated good response of ventricular rate to exercise and no episodes of atrial or ventricular dysrhythmia. It is assumed that embolism occurred due to bradycardia.