Maternal congenital complete heart block in pregnancy: a rare case report

Complete heart block comprises complete absence of AV conduction - none of the supraventricular impulses are conducted to the ventricles. Perfusing rhythm is maintained by a junctional or ventricular escape rhythm. Typically, the patient will have severe bradycardia with independent atrial and ventricular rates. The incidence is 1 in 15,000 to 20,000 live births. Authors present the case report of a primigravida, aged 30 years who presented with amenorrhoea of 35 weeks. She was diagnosed as complete heart block by cardiologist. She had no history of syncopal attacks during childhood or antenatal period. She had a heart rate of 50-52 bpm. ECG showed ventricular escape rhythm with narrow QRS complexes. Echocardiography showed no structural defects. Her elective LSCS was done at 39 weeks after consultation with cardiologist. Patient underwent temporary pacemaker insertion just prior to surgery and she delivered a healthy female baby of weight 3 kg with Apgar 9/10 at 5 mins. She remained asymptomatic during the postoperative period and pacemaker was removed after 30 hours. She was discharged under satisfactory condition on day 6. Patient was counselled for follow up with cardiologist. This case lays emphasis on proper history taking, vitals monitoring, early recognition of undiagnosed cardiac disorders and team work for good maternal and fetal outcome.