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Case Reports
. 2022 Jan 20;15(1):e244598.
doi: 10.1136/bcr-2021-244598.

Pregnancy with complete heart block

Sasmita Swain  1 , Satyanarayan Routray  2 , Sandhyarani Behera  1 , Swayamsiddha Mohanty  1
Affiliations
Case Reports

Pregnancy with complete heart block

Sasmita Swain et al. BMJ Case Rep. .

Abstract

Pregnancy with complete heart block is rare, its management is not streamlined and requires a multidisciplinary team approach involving the obstetrician, cardiologist, anaesthesiologist and neonatologist. High index of suspicion in a woman with slow heart rate and electrocardiographic examination will ensure the diagnosis of this condition. Such patient can be managed conservatively or may require temporary or permanent pacemaker implantation. We present a 26-year-old primigravida with complete heart block at term pregnancy. She was asymptomatic throughout her pregnancy with pulse rate between 50 and 60 beats per minute. Vaginal delivery was planned under continuous ECG monitoring. Isoprenaline drip and temporary pacemaker were kept stand-by. However, for obstetric reasons caesarean section was performed successfully under spinal anaesthesia without a pacemaker. Method of anaesthesia was planned to keep the haemodynamics stable and drugs causing bradycardia were avoided.

Keywords: arrhythmias; pacing and electrophysiology; pregnancy.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
ECG of the patient showing complete heart block, ventricular rate 50 /min, recorded during first diagnosis on 12 March 2020.
Figure 2
Figure 2
ECG after delivery (complete heart block with ventricular rate 50/min).
See this image and copyright information in PMC

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