Complete heart block and fatal right ventricular failure in an infant.

摘要: ### Drs David W. Sapire and Suzanne M. Lopez #### Maternal History The mother of this child was a 22-year-old primigravida in apparent good health. There no clinical or biochemical evidence indicating use ethanol, addictive drugs, other possibly teratogenic substances. Fetal heart rate on ultrasonograms done early her pregnancy about 150 beats per minute. Near the end fifth month pregnancy, she referred to John Sealy Hospital at University Texas Medical Branch (UTMB) because fetal had decreased 86 Although atrial subsequent examinations remained minute, ventricular ranged from 40 50 Two weeks before delivery, rates were 144 47 respectively. When began slow even further, it decided that risk intrauterine death imminent, Caesarean section delivery performed approximately 28th week gestation. There significant family history relevant case. The mother’s serological studies for lupus erythematosus antiphospholipid syndrome negative. #### Infant’s Course The baby major distress just after but increased very little response increasing doses isoproterenol. Within hours birth, an electronic pacemaker advisable. During epicardial placement electrodes near left apex, surgeon noted “infiltrated” right myocardium thin did not respond pacing. Over following weeks, there conducted beats, although regular P waves. Occasional single multiple premature recorded, driven primarily by pacemaker. main problem failure intensive care high-risk …