Congenital heart block

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Congenital heart block
Synonyms	CHB
Pronounce	N/A
Specialty	N/A
Symptoms	Bradycardia, fatigue, dyspnea, syncope
Complications	Heart failure, fetal hydrops, neonatal lupus
Onset	Prenatal or neonatal
Duration	Chronic
Types	N/A
Causes	Autoimmune disease, genetic mutations
Risks	Maternal autoantibodies, family history
Diagnosis	Electrocardiogram, fetal echocardiography
Differential diagnosis	Acquired heart block, myocarditis
Prevention	N/A
Treatment	Pacemaker, medications
Medication	N/A
Prognosis	Variable, depends on severity and treatment
Frequency	Rare
Deaths	N/A

A condition where the heart's electrical conduction system is impaired from birth

Congenital Heart Block

Illustration of the heart's conduction system

Congenital heart block is a rare cardiac condition present at birth, characterized by an impairment in the heart's electrical conduction system. This condition can lead to a slower than normal heart rate, known as bradycardia, and can affect the heart's ability to pump blood efficiently.

Pathophysiology

The heart's electrical conduction system is responsible for generating and transmitting electrical impulses that coordinate the heart's contractions. In congenital heart block, there is a disruption in this system, often at the level of the atrioventricular node or the bundle of His. This disruption can be due to structural abnormalities or the presence of maternal antibodies that cross the placenta and affect the fetal heart.

Causes

Congenital heart block can be associated with several conditions, including:

• Autoimmune diseases: Maternal autoimmune diseases such as systemic lupus erythematosus and Sjogren's syndrome can lead to the production of antibodies that affect the fetal heart.
• Congenital heart defects: Structural abnormalities in the heart can also lead to conduction disturbances.
• Genetic factors: Certain genetic mutations can predispose individuals to congenital heart block.

Symptoms

Symptoms of congenital heart block can vary depending on the severity of the block. They may include:

• Fatigue
• Dizziness or syncope
• Heart failure symptoms in severe cases
• Poor growth and development in infants

Diagnosis

Congenital heart block is often diagnosed through electrocardiogram (ECG) testing, which can reveal abnormalities in the heart's electrical activity. Additional tests such as echocardiography may be used to assess the heart's structure and function.

Treatment

Treatment for congenital heart block depends on the severity of the condition. Options may include:

• Pacemaker implantation: In cases of complete heart block or severe bradycardia, a pacemaker may be necessary to maintain an adequate heart rate.
• Medications: Certain medications can help manage symptoms and improve heart function.
• Monitoring: Regular follow-up with a cardiologist is essential to monitor the condition and adjust treatment as needed.

Prognosis

The prognosis for individuals with congenital heart block varies. With appropriate treatment, many individuals can lead normal lives. However, severe cases may be associated with complications such as heart failure or arrhythmias.

See also

• Heart block
• Bradycardia
• Pacemaker
• Congenital heart disease