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Congenital complete heart block and post-partum focal left ventricular dysfunction.

Ravipati LN, Saba S - Indian Pacing Electrophysiol J (2009)

View Article: PubMed Central - PubMed

Affiliation: Cardiovascular Institute of the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

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Her ECG at that time showed complete heart block with narrow QRS AV nodal escape rhythm at a rate of 30 beats per minute (Figure 1)... In view of her symptoms and significant bradycardia, a dual-chamber pacemaker was implanted endovascularly... The patient was discharged from the hospital feeling significantly improved... Within 24 hours of the procedure, the patient's symptoms of pleuritic chest pain resolved... Serial echocardiograms up to 6 months after her pacemaker implantation, showed persistence of the area of septal, apical, and anterior hypokinesis with mild decrease in systolic function... We present a case of a patient who presented 6 months into her first pregnancy with complete heart block presumably from congenital heart block that may have gone unnoticed for the first 24 years of her life, and who was also diagnosed with an apical cardiomyopathy 3 months after delivering her baby... Last, could the regional wall motion abnormality be secondary to the perforated right ventricular lead causing dyssynchrony in apical contraction? The fact that the patient had always had slow heart rates and that she was minimally symptomatic at presentation supports a diagnosis of congenital complete heart block (3, 4) particularly that the Lyme titers were negative... In summary, we present a case of complete heart block of probable congenital etiology in a pregnant 24 year old patient who developed a new apical left ventricular dysfunction after delivering her baby... Although cases of congenital heart block and of left ventricular dysfunction developing in the post-partum period have been reported in the literature, to our knowledge, this is the first case of both these two entities coexisting in the same patient... Common clinical or genetic predispositions to these two findings may exist but cannot be ascertained at the present time.

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Related in: MedlinePlus

Patient's 12-lead electrocardiogram upon presentation showing complete atrioventricular block, and a junctional escape rhythm at 35 beats per minute.
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Figure 1: Patient's 12-lead electrocardiogram upon presentation showing complete atrioventricular block, and a junctional escape rhythm at 35 beats per minute.

Mentions: Because she was minimally symptomatic, no further testing was done. She went on to deliver a health baby boy and presented again about 3 months later with chest discomfort, lightheadedness and dizziness but no syncope. Her ECG at that time showed complete heart block with narrow QRS AV nodal escape rhythm at a rate of 30 beats per minute (Figure 1). In view of her symptoms and significant bradycardia, a dual-chamber pacemaker was implanted endovascularly. The patient was discharged from the hospital feeling significantly improved.


Congenital complete heart block and post-partum focal left ventricular dysfunction.

Ravipati LN, Saba S - Indian Pacing Electrophysiol J (2009)

Patient's 12-lead electrocardiogram upon presentation showing complete atrioventricular block, and a junctional escape rhythm at 35 beats per minute.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2683640&req=5

Figure 1: Patient's 12-lead electrocardiogram upon presentation showing complete atrioventricular block, and a junctional escape rhythm at 35 beats per minute.
Mentions: Because she was minimally symptomatic, no further testing was done. She went on to deliver a health baby boy and presented again about 3 months later with chest discomfort, lightheadedness and dizziness but no syncope. Her ECG at that time showed complete heart block with narrow QRS AV nodal escape rhythm at a rate of 30 beats per minute (Figure 1). In view of her symptoms and significant bradycardia, a dual-chamber pacemaker was implanted endovascularly. The patient was discharged from the hospital feeling significantly improved.

View Article: PubMed Central - PubMed

Affiliation: Cardiovascular Institute of the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Her ECG at that time showed complete heart block with narrow QRS AV nodal escape rhythm at a rate of 30 beats per minute (Figure 1)... In view of her symptoms and significant bradycardia, a dual-chamber pacemaker was implanted endovascularly... The patient was discharged from the hospital feeling significantly improved... Within 24 hours of the procedure, the patient's symptoms of pleuritic chest pain resolved... Serial echocardiograms up to 6 months after her pacemaker implantation, showed persistence of the area of septal, apical, and anterior hypokinesis with mild decrease in systolic function... We present a case of a patient who presented 6 months into her first pregnancy with complete heart block presumably from congenital heart block that may have gone unnoticed for the first 24 years of her life, and who was also diagnosed with an apical cardiomyopathy 3 months after delivering her baby... Last, could the regional wall motion abnormality be secondary to the perforated right ventricular lead causing dyssynchrony in apical contraction? The fact that the patient had always had slow heart rates and that she was minimally symptomatic at presentation supports a diagnosis of congenital complete heart block (3, 4) particularly that the Lyme titers were negative... In summary, we present a case of complete heart block of probable congenital etiology in a pregnant 24 year old patient who developed a new apical left ventricular dysfunction after delivering her baby... Although cases of congenital heart block and of left ventricular dysfunction developing in the post-partum period have been reported in the literature, to our knowledge, this is the first case of both these two entities coexisting in the same patient... Common clinical or genetic predispositions to these two findings may exist but cannot be ascertained at the present time.

No MeSH data available.


Related in: MedlinePlus