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Case Reports
. 2022 Jul 6;10(19):6602-6608.
doi: 10.12998/wjcc.v10.i19.6602.

Unusual course of congenital complete heart block in an adult: A case report

Li-Na Su  1 , Man-Yan Wu  1 , Yu-Xia Cui  1 , Chong-You Lee  1 , Jun-Xian Song  1 , Hong Chen  2
Affiliations
Case Reports

Unusual course of congenital complete heart block in an adult: A case report

Li-Na Su et al. World J Clin Cases. .

Abstract

Background: Congenital complete heart block (CCHB) with normal cardiac structure and negativity for anti-Ro/La antibody is rare. Additionally, CCHB is much less frequently diagnosed in adults, and its natural history in adults is less well known.

Case summary: A 23-year-old woman was admitted to our hospital for frequent syncopal episodes. She had bradycardia at the age of 1 year but had never had impaired exercise capacity or a syncopal episode before admission. The possible diagnosis of acquired complete atrioventricular block was carefully ruled out, and then the diagnosis of CCHB was made. According to existing guidelines, permanent pacemaker implantation was recommended, but the patient declined. With regular follow-up for 28 years, the patient had an unusually good outcome without any invasive intervention or medicine. She had an uneventful pregnancy and led a normally active life without any symptoms of low cardiac output or syncopal recurrence.

Conclusion: This case implies that CCHB in adulthood may have good clinical outcomes and does not always require permanent pacemaker implantation.

Keywords: Acquired complete atrioventricular block; Case report; Congenital complete heart block; Pacemaker implantation; Syncope.

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Conflict of interest statement

Conflict-of-interest statement: The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Electrocardiography on admission on admission. Complete atrioventricular block with junctional escape at 48 beats per minute.
Figure 2
Figure 2
Cardiovascular contrast-enhanced magnetic resonance imaging. A: Cardiac magnetic resonance image (MRI) of the systolic phase of four chambers and axial view showed normal atrioventricular size and myocardial function; B: Cardiac MRI of the diastolic phase of four chambers and axial view showed normal atrioventricular size and myocardial function; C: T2-weighted image did not reveal any myocardial edema; D: Late gadolinium enhancement revealed no definite area of hyperenhancement to suggest myocardial fibrosis.
Figure 3
Figure 3
Electrocardiography at 28 years of follow-up. Complete atrioventricular block with junctional escape at 42 beats per minute.
See this image and copyright information in PMC

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