Complete heart block in pregnancy

Fiser, Wesley; Hayes, Kevin; Paydak, Hakan

doi:10.5430/crim.v4n2p22

Cited by 3 publications

(3 citation statements)

References 3 publications

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“…As we have reported in a previous case report, 3 she had a similar presentation during her previous pregnancy at 26 weeks, with increasing exertional dyspnea and lightheadedness without syncope. The ECG at that time showed CHB, and her transthoracic echocardiogram was unremarkable.…”

Section: Case Reportsupporting

confidence: 77%

“…Our group also reported the case of transient CHB in this same patient in 2017. 3 At that time, the CHB was hypothesized to be secondary to possible myocarditis from a viral exanthem. With the recurrence of the CHB in her next pregnancy, we now believe it is a pregnancy-related transient event, which we hypothesize is secondary to conduction defects from physiological atrial stretching during pregnancy or estrogen-mediated cellular signaling changes.…”

Section: Discussionmentioning

confidence: 99%

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Recurrence of complete heart block in pregnancy

Young

Turaga

Amisha

et al. 2021

HeartRhythm Case Reports

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Case Reportsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Recurrence of complete heart block in pregnancy

Young

Turaga

Amisha

et al. 2021

HeartRhythm Case Reports

Self Cite

View full text Add to dashboard Cite

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“…30701/ijc.1015 O n l i n e F i r s t atropine or exercise, the most likely level of block is at the His bundle, and pacing may be needed (4,5). In this case, physical activity test is not possible because of general condition of the patient.…”

mentioning

confidence: 99%

Complete Heart Block In Pregnancy : A Case Report

Yafi

Noviani²,

Saputri³

et al. 2021

IJC

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Background: Complete heart block occurs due to various pathological conditions that cause an infiltration, fibrosis, or lose the connection from a part of the cardiac conduction system. Complete heart block in pregnancy is often caused by congenital anomalies. Around 30% cases, complete heart block remain asymptomatic and not detected until adulthood and may present in pregnancy state and puerperium. When the reversible cause of the AV Block cannot be found, the permanent pacemaker or temporary pacemaker may be indicated when the patients show the symptoms. Case Illusration: A-21 year old female, G2P0A1 preterm pregnancy (27-28 weeks) with bradycardia. From electrocardiograph examination revealed Total AV Block with junctional escape rhytym. Transthoracic echocardiogram shows massive tricuspid regurgitation, early phase of peripartum cardiomyopathy and ejection fraction 36-40%. Caesarean section was peformed due to PPROM. A male baby was born with birth weight of 1100 grams, 32 centimeters of body length and APGAR score of 7/9. The baby was died in NICU on day care 4th, with suspected respiratory problem. Conclusion: Complete heart block in pregnancy is a rare condition. This condition could remain asymptomatic and not detected until pregnancy. Multidisciplinary approach, close monitoring of the symptoms and cardiac functions are needed for patients with CHB.

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Reversible Complete Heart Block in a Pregnant Woman Responding to Steroids: A rare Case Report

Mahadevappa

Patil

Tripathi

et al. 2023

NEMJ

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Background: Complete heart block (CHB) is the total absence of conduction from atria to ventricles with an escape rhythm most commonly arising from the AVN or His bundle. CHB in pregnancy is very rare, and most reported cases are due to congenital variety, where the pre-existing CHB from birth is either detected incidentally or presented with symptoms during pregnancy. Pregnancy is associated with various physiological changes, such as a pro-inflammatory, hypercoagulable state with possible oedema of the heart's conduction system, which may rarely give rise to CHB. There are no clear guidelines to manage CHB complicating pregnancy. Case presentation: An asymptomatic 27-year-old lady with G2P1L1, 39 weeks of gestation with breech presentation, was referred for delivery given the low maternal heart rate of 40 bpm. Per abdominal examination revealed a term size uterus with active contractions and a fetal heart rate of 140bpm. An ECG revealed a CHB with an escape rate of 40 bpm. Other routine investigations were normal, with negative serological evaluation for hepatitis B, C, and HIV. ANA and Anti-Ro ⁄ SSA antibodies. She underwent an emergency LSCS under spinal anaesthesia with a backup temporary pacemaker (TPM). She received a short course of empirical steroid therapy for three days as there were no obvious secondary causes for CHB, which reverted to sinus rhythm after 48 hours. Discussion: CHB complicating pregnancy with or without symptoms may require definitive therapy in the form of permanent pacemaker implantation. However, the insertion of a TPM for managing pregnancy is controversial as opinion in the literature is divided. There are no reports of CHB occurring in pregnancy without congenital or other known acquired causes. In the reported case, the CHB reverted to sinus rhythm with a short course of IV steroid therapy without any subsequent need for a PPM implantation. Conclusion: Congenital CHB remains the most common cause of rarely seen CHB complicating pregnancy. Through the conduction system oedema and inflammation, physiological changes in gestation may rarely cause CHB during pregnancy. In the absence of congenital CHB and other demonstrable acquired causes, a short course of steroid therapy may reverse the CHB avoiding PPM implantation as shown in the reported case.

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Complete heart block in pregnancy

Cited by 3 publications

References 3 publications

Recurrence of complete heart block in pregnancy

Recurrence of complete heart block in pregnancy

Complete Heart Block In Pregnancy : A Case Report

Reversible Complete Heart Block in a Pregnant Woman Responding to Steroids: A rare Case Report

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