Congenital complete heart block and spinal anaesthesia for caesarean section

Abstract

Congenital complete heart block could be absolutely asymptomatic. Increased awareness of suspecting an atrioventricular heart block in patients with slow heart rate and electrocardiograph examination will ensure recognition of this problem. The possibility of sudden cardiac death in these patients should not be forgotten. The goal in the peri-operative anaesthetic management is to preserve the heart rate and maintain haemodynamic stability. Herein, we present a case of congenital complete heart block posted for elective caesarean section for an obstetric indication. We would like to highlight the advantage of bupivacaine–fentanyl combination in maintaining haemodynamic stability and peri-operative heart rate control with temporary pacemaker.

Caesarean section under spinal and epidural anesthesia in complete atrioventricular block without a pacemaker: a rare case report

“…Asymptomatic women who responded to exercise or atropine by an increase in heart rate can be managed without pacemaker. 2,3 Studies suggested that regional anaesthesia is safe in pregnant women with cardiac disease undergoing caesarean section. Although the risk of hypotension is less with epidural technique, it may not be suitable in emergency situations with time constraints.…”

Emergency Cesarean Section in a Patient with Congenital Complete Heart Block under General Anesthesia: A Case Report

“…9 Umesh et al reported a case of congenital complete heart block and spinal anesthesia for cesarean section. 10 Neuraxial blockade causes sympathetic blockade, which demands an increase in heart rate; so it becomes mandatory to accelerate the heart rate using a pacemaker. The heart rate required to meet the cardiac output is unpredictable.…”

Cesarean delivery in congenital heart block and need of temporary pacing: A case report

“…QRS complexes in ECG are wide, and the rate is lower and is not increased by exercise or atropine. [2] Our case was detected with congenital CHB. In most studies of pregnancy with CHB, patients were asymptomatic excepting one, which reported 29% incidence of syncope and 38% of palpitations.…”