A Case of Congenital Complete Heart Block

In complete heart block(CHB), there is a complete failure of the atrial impulse leading into a ventricular response, the atria and ventricles beat independently, with the latter having a slower rate. Approximately one-third of infants with congenital CHB have associated structural heart disease such as corrected transposition of the great arteries, single ventricle, and the heterotaxy syndrome. For those patients without associated anomalies in whom bradycardia causes heart failure unresponsive to drugs, a pacemaker is necessary. We report a case of congenital complete heart block showing a ventricular beat of 57 /min despite atrial beat of 125/min. The mother of the baby was asymptomatic but her serologic tests were positive for connective tissue disease. The patient had positive serologic tests for anti-Ro antibody and anti-La antibody but associated structural heart anomalies were not found. He remained well without signs and symptoms of heart failure and no treatment was required except 02 supply.

The Significance of the EEG, Brainstem Auditory Evoked Potential ( BAEP ) and Brain Ultrasonographic Findings of Asphyxiated Newboms on the Neurological Outcome

PURPOSE: The objective of this study was to analyze the relationship between the electrophysiological studies(EEG and BAEP) and brain ultrasonography and the prognosis of the newborn infants with asphyxia. METHODS: Clinical records, including electrophysiological findings of EEG and BAEP and brain ultrasonography, of 29 term infants with neonatal asphyxia, who had been admitted to the Pediatric Department of Chosun University Hospital between January 1994 and June 1997 were reviewed retrospectively. RESULTS: Out of the 29 cases that returned for follow up, 23 cases were neurodevelopmentally normal, but 6 cases showed delayed development on the Korean Denver Developmental Scale Test(KDDST). Of 19 cases with abnormal EEG findings, 5 showed delayed developrnent on the KDDST(P>0.05). Follow up EEG was performed in 10 cases', 8 of them were normalized, and two remained abnormal without delayed development on the KDDST. Of 8 cases with abnormal brain ultrasonographic findings, 5 showed delayed development on the KDDST(P0.05). Follow up BAEP was performed in 8 cases, and all cases were normal. CONCLUSION: These results suggest that abnormal findings of EEG and BAEP in the asphyxiated term newborn were reversible, but abnormal brain ultrasonographic findings, especially intracranial hemorrhage, were significantly correlated with delayed development.