Document Detail


Congenital complete heart block and maternal connective tissue disease.
MedLine Citation:
PMID:  16815568     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Congenital complete heart block can be isolated or can occur in association with other structural heart diseases. Isolated congenital complete heart block (CCHB) is due to transplacental transfer of autoantibodies from mothers with connective tissue disease. Congenital heart block is usually complete, but incomplete blocks, sinus bradycardia and QTc prolongation are also reported. Anti SS A and Anti SS B antibodies transferred from mothers have inflammatory and arrhythmogenic effects in the fetal conduction system. Cardiac manifestations reported include dilated cardiomyopathy, endocardial fibroelastosis and mitral insufficiency. Low ventricular rate, QT prolongation and arrhythmias on monitoring are high risk features. CCHB has a mortality of 30%, and 60% of infants require pacemaker therapy. Fetal echocardiography is useful in early diagnosis. Prophylactic steroid therapy is controversial. Beta adrenergic agonists were tried in mothers with fetuses having congenital heart block to increase fetal heart rate. Early pacemaker therapy is indicated in patients with symptomatic bradycardia and ventricular dysfunction. The indications for pacing in congenital heart block continue to evolve with advances in techniques and most of these children will ultimately require permanent pacemakers by adulthood.
Authors:
N Jayaprasad; Francis Johnson; K Venugopal
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Publication Detail:
Type:  Journal Article; Review     Date:  2006-06-30
Journal Detail:
Title:  International journal of cardiology     Volume:  112     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-09-18     Completed Date:  2006-10-26     Revised Date:  2007-02-22    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  153-8     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Medical College, Calicut, Kerala State, 673008, India. drjpn76@yahoo.co.in
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MeSH Terms
Descriptor/Qualifier:
Autoantibodies / immunology
Cardiomyopathy, Dilated
Connective Tissue Diseases / complications*,  immunology
Female
Heart Block / congenital*,  diagnosis,  mortality,  physiopathology
Humans
Immunohistochemistry
Infant, Newborn
Lupus Erythematosus, Systemic / complications
Pacemaker, Artificial
Pregnancy
Pregnancy Complications* / immunology
Pregnancy Outcome
Ultrasonography, Prenatal
Chemical
Reg. No./Substance:
0/Autoantibodies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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