Nürnberg J H, Senft G, Sperling P, Lange P E
Deutsches Herzzentrum Berlin, Abteilung für angeborene Herzfehler/Kinderkardiologie, Germany.
Klin Padiatr. 2002 May-Jun;214(3):113-6. doi: 10.1055/s-2002-30145.
A 9 year old boy presented with uncharacteristic gastroenteric complaints due to a complete heart block 9 days after an uneventful varicella infection. Echocardiographically there were no signs of gross myocardial involvement. Bradydysrhythmia necessitated isoproterenol application however without the need for temporary transvenous cardiac pacing. After a short period of second-degree atrioventricular block and transient left bundle branch block the rhythm recovered completely and sinus rhythm is maintained so far. Worrying is the delayed onset of this complication after an uneventful course of a typically undangerous children's disease. Presumably a remaining inflammatory reaction in different parts of the specific conducting system has to be assumed. The long lasting prognosis of the atrioventricular conduction properties remains to be seen.
一名9岁男孩在水痘感染过程顺利9天后,因完全性心脏传导阻滞出现非典型的胃肠道症状。超声心动图检查未发现明显心肌受累迹象。心动过缓性心律失常需要应用异丙肾上腺素,但无需临时经静脉心脏起搏。经过短时间的二度房室传导阻滞和短暂的左束支传导阻滞,心律完全恢复,至今维持窦性心律。令人担忧的是,在一种典型的低危儿童疾病病程顺利后,这种并发症出现得较晚。推测特定传导系统不同部位可能存在残留的炎症反应。房室传导特性的长期预后仍有待观察。