Presyncope Due to a Complete Atrioventricular Block Revealing a Rheumatic Heart Disease

Souilmi Fz Atmani S

doi:10.4172/2165-7920.1000386

Abstract

First degree Atrio Ventricular (AV) block is a common manifestation of acute Rheumatic Fever (RF) and is included in the Jones criteria but Wenckebacks phenomena and complete heart block are rarely described in the RF. Presyncope occurring in RF was rarely reported. We report the case of a young 14 years old boy with rheumatic heart disease revealed by presyncope due to an third degree AV block. Rapid improvement was obtained under corticosteroids.

Highlights

Various rhythm and conduction abnormalities can develop in acute Rheumatic Fever (RF)
Complete atrioventricular block (AV) block associate or not to Adams-Stokes syndrome is exceptionally found in the acute RF [1]
We report an unusual mode of revelation of acute RF, presyncope secondary to a complete atrioventricular block in an adolescent of 14 years

Summary

Introduction

Various rhythm and conduction abnormalities can develop in acute Rheumatic Fever (RF). The most common conduction abnormalities are sinus tachycardia, atrioventricular block (AV) of the first degree with prolongation of the PR interval (greater than 0.16 s). We report an unusual mode of revelation of acute RF, presyncope secondary to a complete atrioventricular block in an adolescent of 14 years. A 14 year old boy, weight 42 kg was admitted to the pediatric emergency room for several episodes of presyncope episodes which occurred 3 days before. He had complained of transient thoracic pain the day before. The first ECG recording revealed complete heart block (Figure 1). Intramuscular injections of benzyl penicillin (1.2 million IU) every 3 weeks were prescribed for secondary prophylaxis

Discussion

Findings

Conclusion