Affiliation:
1. Veltischev Research and Clinical Institute for Pediatrics and Pediatric Surgery of the Pirogov Russian National Research Medical University
Abstract
The article presents a clinical case of paroxysmal atrioventricular block, which is a rare and difficult to diagnose cause of syncope, which makes it difficult for specialists to make a correct diagnosis and determine the tactics of patient management. Purpose. To demonstrate a clinical case, in which comprehensive methods of examination were carried out to identify the cause of syncope, and to show the need of understanding its pathogenesis. For differential diagnosis, it is necessary to carry out not only routine examination methods, but also to use drug tests, as well as long-term monitoring devices (multi-day daily Holter monitoring, loop recorders of long-term ECG recording, smart watches, etc.), which help to find the cause of syncope. According to the clinical recommendations, patients with atrioventricular block and clinical symptomatology, require continuous cardiac pacing in order to prevent asystole with potential sudden cardiac death.
Publisher
The National Academy of Pediatric Science and Innovation
Subject
Pediatrics, Perinatology and Child Health
Reference13 articles.
1. Pratt J., Fleisher G. Syncope in children and adolescents. Pediatr. Emerg Care 1989; 5(2): 80–82. DOI: 10.1097/00006565–198906000–00002
2. Shkol’nikova M.A., Polyakova E.B., Il’darova R.A., Trofimova T.A., Leont’eva I.V., Kovalyov I.A. Syncopal conditions in children and adolescents. Vestnik Aritmologii 2017; 87: 59–71. (in Russ.)
3. Milena A., Michele B. Syncope and paroxysmal atrioventricular block. J Arrhythmia 2017; 33(6): 562–567. DOI: 10.1016/j.joa.2017.03.008
4. Sachs A., Traynor R. Paroxysmal complete auriculo-ventricular heart-block. Am Heart J 1933; 9: 267–271.
5. Divakara Menon S.M., Ribas C.S., Ribas Meneclier C.A., Morillo C.A. Intermittent atrioventricular block: What is the mechanism? Heart Rhythm 2012; 9(1): 154–155. DOI: 10.1016/j.hrthm.2010.11.012