Bloqueo aurículo-ventricular congénito: reporte de un caso, revisión de la literatura / Congenital auriculoventricular block: a case report, literature review

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

Complete heart block complicating acute myocardial infarction [pattern, management and in-hospital outcome]

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

Uso de simpaticomimético em bloqueio atrioventricular fetal / Sympathomimetic Drug Therapy in Fetal Complete Heart Block

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

Role of aminophylline in atropine resistant atrioventricular block.

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.