Department of Pediatrics, College of Medicine, Soonchunhyang University, Cheonan, Korea.
Korean Circ J. 2009 Mar;39(3):121-3. doi: 10.4070/kcj.2009.39.3.121. Epub 2009 Mar 25.
Rheumatic fever is an acute inflammatory sequela following a group A, beta-hemolytic streptococcal infection. Rheumatic fever is characterized by polyarthritis, carditis, chorea, subcutaneous nodules, and erythema marginatum as the major diagnostic criteria. Rarely, advanced heart block may also occur. A 13-year-old boy was admitted to the Pediatric Department for evaluation and management of complete atrioventricular block. The patient had exertional dyspnea for 1 month. Based on the findings of mitral regurgitation, fever, elevated acute phase reactants, and a high antistreptolysin O titer, the patient was diagnosed with rheumatic fever. A benzathine penicillin injection was administered, as well as salicylate therapy. On the 5(th) day of hospitalization, the electrocardiogram revealed a normal sinus rhythm with a 1(st) degree atrioventricular block. After discharge, the electrocardiogram normalized with the monthly penicillin injections. Herein we report a case of complete atrioventricular block associated with rheumatic fever. The heart block resolved without specific cardiac treatment, other than a non-steroidal anti-inflammatory medication.
风湿热是 A 组β溶血性链球菌感染后的一种急性炎症后遗症。风湿热的主要诊断标准为多发性关节炎、心肌炎、舞蹈病、皮下结节和红斑。极少数情况下，也可能发生高级心脏传导阻滞。一名 13 岁男孩因完全性房室传导阻滞入住儿科病房进行评估和治疗。患者有 1 个月的劳累性呼吸困难。根据二尖瓣反流、发热、急性期反应物升高和抗链球菌溶血素 O 滴度升高的结果，该患者被诊断为风湿热。给予苄星青霉素注射和水杨酸盐治疗。住院第 5 天，心电图显示窦性节律伴 1 度房室传导阻滞。出院后，每月注射青霉素，心电图恢复正常。本文报告了 1 例风湿热相关的完全性房室传导阻滞。心脏阻滞未经特定的心脏治疗而缓解，除了非甾体抗炎药物治疗。
