| Nocturnal enuresis secondary to heart block: report of cure by cardiac pacemaker implantation. | |
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MedLine Citation:
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PMID: 8337031 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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This report describes an unusual case of secondary nocturnal enuresis presumptively secondary to progressive bradycardia from complete heart block. Congenital complete heart block occurs in approximately 1 of 22,000 livebirths and is typically associated with structural congenital heart disease or maternal collagen vascular diseases. It can be entirely asymptomatic during infancy and childhood, depending in part on the escape rate and rhythm and other hemodynamic variables. The case described above was not diagnosed until the patient coincidentally underwent cardiac monitoring. The picture was confusing initially, as a tricyclic antidepressant medication had been ingested. Heart block is one of the known cardiovascular effects of tricyclic antidepressant overdose. However, the conduction disturbance should have resolved as the drug was excreted from the body. As children with congenital complete heart block get older, the ventricular escape rate typically decreases. In addition, as activity increases with age, more demand is placed for cardiac output. The resting end-diastolic volume is increased to elevate stroke volume in compensation for lower heart rate. As the escape rate decreases and the metabolic demand increases, patients with congenital complete heart block then may begin to develop symptoms. Typical symptoms in children include dizziness, Stokes-Adams syncopal attacks, fatigue, daytime somnolence, and other somatic complaints. Bedwetting has not been reported as an initial symptom, but in this case is likely secondary to the excessive somnolence and difficulty with arousal.(ABSTRACT TRUNCATED AT 250 WORDS) |
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Authors:
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C I Berul; J D Murphy |
Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Pediatrics Volume: 92 ISSN: 0031-4005 ISO Abbreviation: Pediatrics Publication Date: 1993 Aug |
Date Detail:
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Created Date: 1993-08-24 Completed Date: 1993-08-24 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0376422 Medline TA: Pediatrics Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 284-5 Citation Subset: AIM; IM |
Affiliation:
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Division of Cardiology, Children's Hospital of Philadelphia, PA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Child, Preschool Enuresis / etiology* Heart Block / complications*, congenital, therapy* Humans Male Pacemaker, Artificial* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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