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. 2009 Mar;39(3):121-3.
doi: 10.4070/kcj.2009.39.3.121. Epub 2009 Mar 25.

Complete atrioventricular block in an adolescent with rheumatic Fever

Gyeong-Hee Yoo  1
Affiliations

Complete atrioventricular block in an adolescent with rheumatic Fever

Gyeong-Hee Yoo. Korean Circ J. 2009 Mar.

Abstract

Rheumatic fever is an acute inflammatory sequela following a group A, beta-hemolytic streptococcal infection. Rheumatic fever is characterized by polyarthritis, carditis, chorea, subcutaneous nodules, and erythema marginatum as the major diagnostic criteria. Rarely, advanced heart block may also occur. A 13-year-old boy was admitted to the Pediatric Department for evaluation and management of complete atrioventricular block. The patient had exertional dyspnea for 1 month. Based on the findings of mitral regurgitation, fever, elevated acute phase reactants, and a high antistreptolysin O titer, the patient was diagnosed with rheumatic fever. A benzathine penicillin injection was administered, as well as salicylate therapy. On the 5(th) day of hospitalization, the electrocardiogram revealed a normal sinus rhythm with a 1(st) degree atrioventricular block. After discharge, the electrocardiogram normalized with the monthly penicillin injections. Herein we report a case of complete atrioventricular block associated with rheumatic fever. The heart block resolved without specific cardiac treatment, other than a non-steroidal anti-inflammatory medication.

Keywords: Atrioventricular block; Rheumatic fever.

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Figures

Fig. 1
Fig. 1
Electrocardiogram depicts complete heart block with a ventricular rate of 77 on the day of admission.
Fig. 2
Fig. 2
Electrocardiogram on the 3rd day of hospitalization depicts 2nd degree atrioventricular block (Mobitz II) combined with PR prolongation.
Fig. 3
Fig. 3
Electrocardiogram shows 1st degree atrioventricular block on the 5th day of hospitalization.
Fig. 4
Fig. 4
Electrocardiogram shows a normalized PR interval at the outpatient department visit.
See this image and copyright information in PMC

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