Lenox C C, Zuberbuhler J R, Park S C, Neches W H, Mathews R A, Zoltun R
Pediatrics. 1978 Apr;61(4):599-603.
In spite of general complacency about first-degree heart block in acute rheumatic fever, abnormal conduction with dysrhythmias, occasional complete heart block, and, rarely, Stokes-Adams attacks are important early signs of acute rheumatic fever and may precede other signs. Every person with episodic fainting is entitled to an ECG, and frequent ECGs are imperative in any case of rheumatic fever with signs of arrhythmias. Changing atrioventricular block necessitates continuous monitoring for dysrhythmias. A 13-year-old boy who appeared with Stokes-Adams attacks secondary to acute rheumatic fever was successfully treated by temporary pacing.
尽管人们对急性风湿热中的一度房室传导阻滞普遍存在自满情绪，但伴有心律失常的异常传导、偶尔出现的完全性心脏传导阻滞以及罕见的斯托克斯-亚当斯发作是急性风湿热的重要早期体征，可能先于其他体征出现。每个有发作性昏厥的人都有权接受心电图检查，而且在任何伴有心律失常体征的风湿热病例中，频繁进行心电图检查都是必要的。房室传导阻滞的变化需要持续监测心律失常。一名13岁男孩因急性风湿热继发斯托克斯-亚当斯发作，通过临时起搏成功治愈。
