ABSTRACT
Se presenta un caso de bloqueo aurículo-ventricular congénito diagnosticado prenatalmente en un feto de 30 semanas. Se produce el parto por vía transpelviana, eutócico, obteniéndose recién nacido vivo con peso, talla y apgar normales. Se revisa la etiopatogenia del BAVC en relación con los daños autoinmunes al sistema fetal de conducción por anticuerpos IgG anti SSA/Ro y anti SSB/La derivados de madres que sufren enfermedades autoinmunes. Se discute el diagnóstico, cuadro clínico, tratamiento y pronóstico del BAVC. Se exponen malformaciones menores presentes en nuestro caso, no reportadas anteriormente en relación con el BAVC
Subject(s)
Humans , Adult , Female , Pregnancy , Infant, Newborn , Antibodies, Anti-Idiotypic , Autoimmune Diseases , Heart Block/congenital , Heart Block/drug therapy , Heart Block , Fetal Diseases , Heart Defects, Congenital , Immunoglobulin G , Ultrasonography, PrenatalSubject(s)
Humans , Female , Pregnancy , Infant, Newborn , Adult , Antibodies, Antinuclear/immunology , Autoantibodies/immunology , Heart Block/congenital , Heart Block/diagnosis , Heart Block/drug therapy , Dexamethasone/therapeutic use , Hepatomegaly/congenital , Hepatomegaly/therapy , Maternal-Fetal Exchange/immunology , Pacemaker, Artificial , Pregnancy Complications, Cardiovascular/diagnosis , Prenatal DiagnosisSubject(s)
Humans , Clinical Protocols , Myocardial Infarction/complications , Myocardial Infarction/drug therapy , Myocardial Infarction/therapy , Angina Pectoris/drug therapy , Angina Pectoris/etiology , Arrhythmias, Cardiac/drug therapy , Arrhythmias, Cardiac/therapy , Heart Block/drug therapy , Heart Septal Defects, Ventricular/diagnosis , Pericarditis/drug therapy , Heart Rupture, Post-Infarction/diagnosis , Ventricular Premature Complexes/drug therapyABSTRACT
852 consecutive patients admitted to the CCU in Matareia Teaching Hospital [MTH] were studied to assess the incidence of complete heart block [CHB] in acute myocardial infarction [AMI], and evaluate its outcome and the type of therapy applied. Out of 605 patients with AMI, 24 developed CHB. Inferior wall infarction was present in 18, anterior AMI in 4, and subendocardial in 2 cases. The onset of block in all cases was in the first 2 days. Fifteen patients were treated medically and 9 required temporary pacing. Only 3 cases had persistent block and required permanent pacing. The overall outcome was good, whatever the therapeutic modality adopted
Subject(s)
Humans , Heart Block/therapy , Heart Block/drug therapy , Pacemaker, Artificial , Heart Block/epidemiology , Cardiac Pacing, ArtificialABSTRACT
Gestante de 34 semanas foi encaminhada para ecocardiografia fetal por bradicardia e hidropsia fetal ao ultrassom obstétrico. A anatomia cardíaca mostrou-se normal, porém, foi diagnosticado bloqueio atrioventricular total com freqüência ventricular de 22 bpm e freqüência atrial de 101 bpm. Através de cordocentese, injetou-se na veia umbilical 0,06µg de isoproterenol, elevando-se a freqüência ventricular para 40bpm e a atrial para 171bpm. A utilizaçäo de simpaticomiméticos diretamente na veia umbilical fetal é um procedimento relativamente simples e, em muitos casos, pode evitar a hidropsia e o óbito
Subject(s)
Humans , Female , Adult , Isoproterenol/therapeutic use , Heart Block/drug therapy , Fetal Diseases/drug therapy , Hydrops Fetalis/etiology , Heart Block/complicationsABSTRACT
Atrioventricular (AV) block may be induced by ischaemia as a result of production of adenosine, a metabolite that accumulates during hypoxia and ischaemia. Adenosine antagonism has been shown to reverse experimental AV node block in dogs. Recently, theophylline has been shown to be highly effective in diminishing the frequency and severity of bradycardia in newborn infants with apnoea-bradycardia spells. We report here a case of acute inferior wall myocardial infarction who developed atropine resistant AV block which was reversed by aminophylline, a competitive, antagonist of adenosine.