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Isolated Congenital Complete Heart Block in a Five-year-old Seronegative Girl Born to a Woman Seropositive for Human Immunodeficiency Virus: A Case Report.

Pallangyo, P., Mawenya, I., Nicholaus, P., Mayala, H., Kalombola, A., Sharau, G., Majani, N. and Janabi, M. (2016) Isolated Congenital Complete Heart Block in a Five-year-old Seronegative Girl Born to a Woman Seropositive for Human Immunodeficiency Virus: A Case Report. Journal of medical case reports, 10 (1). p. 288. ISSN 1752-1947

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Abstract

Congenital complete heart block is a life-threatening condition which is highly associated with autoimmune and connective tissue disorders. Presence of maternal autoantibodies for associated conditions increases the risk of delivering a child with congenital complete heart block, however, less than a half of all women with such antibodies are symptomatic even after delivery. Mortality rate is highest during the neonatal period (45 %) and about two-thirds of all cases will require permanent pacing at some point in their lives. We report a case of isolated complete heart block in a 5-year-old HIV-free girl of African descent born to an HIV-infected woman with no prior history of autoimmune disorders. She was referred to us with chief complaints of recurrent syncopal attacks and effort intolerance since birth. A physical examination was unremarkable except for her being small for her age (body mass index 16.3 kg/m(2)) and bradycardia. Her vital signs were within acceptable range with the exception of her pulse rate, which ranged between 22 and 34 beats/minute. An echocardiogram revealed a sinus bradycardia, otherwise a structurally normal heart. An electrocardiogram showed atrioventricular dissociation in keeping with third-degree atrioventricular block. The child underwent a permanent epicardial pacemaker insertion and has been symptom-free following pacing. Despite its infrequency and life-threatening potential, patients with congenital complete heart block have an excellent survival rate with timely diagnosis and intervention. An incidental detection of bradycardia in a fetus during routine obstetrical ultrasound examination should increase the index of suspicion for congenital complete heart block and warrant a screening for associated maternal autoantibodies.

Item Type: Article
Keywords: Congenital complete heart block, Congenital third-degree AV block, Isolated congenital heart block, Recurrent syncopal attacks, Symptomatic bradycardia, Case report
Subjects: Non-communicable disease (NCD) > Congenital conditions
Divisions: Muhimbili University of Health and Allied Sciences (MUHAS)
Depositing User: Mr Joseph Madata
Date Deposited: 28 Aug 2017 07:51
Last Modified: 28 Aug 2017 07:51
URI: http://ihi.eprints.org/id/eprint/4229

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