Clinical findings such as murmurs and cardiomegaly in congenital complete atrioventricular block can falsely suggest associated congenital heart lesions, highlighting the importance of careful clinical and hemodynamic assessment.
The diagnosis of congenital complete atrioventricular block usually offers little difficulty. There remains, however, the problem of interpreting certain clinical findings, including systolic and diastolic murmurs and cardiomegaly, which are sometimes falsely suggestive of an associated congenital heart lesion. The clinical, radiologic, and electrocardiographic findings in 27 children with congenital complete heart block have been analyzed in terms of the hemodynamic abnormalities found at cardiac catheterization in 12 of these patients.
Paul et al. (1958) studied this question.