Commotio Cordis Presenting as Temporary Complete Atrioventricular Block in a 2-Year Old Girl with Congenitally Corrected Transposition of Great Arteries

Abstract

We report a 2-year old girl with the congenitally corrected transposition of the great arteries (ccTGA) that presented the transient complete atrioventricular (AV) block after slight chest blow. She ran around with the elder sister at the house and fell to the floor and her elder sister fell and landed on her. After that, she was cyanotic, pale and transient loss of consciousness. Upon the emergency department, her consciousness was clear but her face was still pale. On the electrocardiogram (ECG), it demonstrated a complete AV block with her heart rate was 78 beat per minuets (bpm). After admission, the monitor ECG showed from the 2:1 AV block to the Wenckbach type second-degree AV block. At 2nd day of admission, on 12-lead ECG, there are significant ST and T-wave abnormalities in precordial leads but she did not fell chest pain and was normal physical examination. Echocardiography demonstrated to be normal contractility of systemic right ventricle. On 12-lead ECG, first-degree AV block and the ST and T-wave abnormalities improved gradually without abnormal Q-wave. This is the first report of ccTGA in which a transient complete AV block was naturally recovered by presenting as commotio cordis.