Hejazi Rayan, Balubaid Marwan, Alata Jameel, Waggass Rahaf
National Guard Health Affairs, Jeddah, Saudi Arabia.
Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
BMJ Case Rep. 2019 Apr 24;12(4):e228642. doi: 10.1136/bcr-2018-228642.
Tetralogy of Fallot (TOF) is the most common form of cyanotic congenital heart disease beyond the age of 3 months. Complete heart block (CHB) is rare but a serious sequalae post-repair of TOF. We present a case of an 18-month-old child who developed late CHB after around 1 year of the corrective surgery of the congenital anomaly. On the regular follow-up visit, the patient assessment was unremarkable. However, there was bradycardia, 55 beats/min. The ECG showed complete atrioventricular dissociation. Echocardiogram was done and demonstrated severe tricuspid regurgitation (TR). The patient required a permanent pacemaker and he is currently well. We are presenting this case as a late unexpected CHB, with a possibility of progressive right-side dilatation as a contributing factor to CHB due to severe TR.
法洛四联症（TOF）是3个月龄以上最常见的青紫型先天性心脏病。完全性心脏传导阻滞（CHB）虽罕见，但却是TOF修复术后的严重后遗症。我们报告一例18个月大的儿童，在先天性畸形矫正手术约1年后发生迟发性CHB。在常规随访中，患者评估无异常。然而，出现了心动过缓，心率55次/分钟。心电图显示完全性房室分离。进行了超声心动图检查，显示严重三尖瓣反流（TR）。该患者需要植入永久性起搏器，目前情况良好。我们将此病例呈现为迟发性意外CHB，严重TR导致右侧渐进性扩张可能是CHB的一个促成因素。
