Bloqueo aurículo-ventricular congénito completo y anticuerpos maternos anti-Ro positivos

Abstract

Congenital heart block is a rare anomaly produced by an injury to the specialized cardiac conducting tissue, with secondary alterations in the transmission of stimuli from the atria to the ventricles. This defect can be associated with structural heart disease and maternal autoimmune diseases such as systemic lupus erythematosus syndrome or the presence of anti-Ro and anti-La autoantibodies. Prenatal diagnosis is given by echocardiography, which shows persistent fetal bradycardia, and allows detection of fetal hemodynamic deterioration, requiring finalization of pregnancy.Intrauterine therapy consists of sympathomimetics and steroid agents and a pacemaker can be implanted in the newborn as a definitive treatment at the end of the pregnancy.We report the case of an asymptomatic mother at week 26 of pregnancy who presented to the emergency department with abdominal pain. On examination, an anomalous fetal heart rate was detected and congenital heart block was confirmed. The only abnormal result of maternal blood test was the presence of positive anti-nuclear antibodies and anti-Ro autoantibodies.