Complete heart block secondary to viral myocarditis can be managed conservatively with temporary pacing while awaiting spontaneous recovery of conduction.
May support temporary pacing as bridge in select myocarditis block cases; hypothesis-generating, needs prospective validation before practice change.
We report here a case of complete heart block from coxsackie myocarditis in a 15- year-old, treated by temporary pacing. The patient presented with history of fever five days prior to admission. This lasted for three days, followed by history of chest pain and fatiguability. ECG on admission revealed complete heart block, wide QRS escape. Blood examination revealed IgG antibody to Coxsackie virus. The patient was put on backup temporary pacing. Spontaneous recovery was seen with reversion to sinus rhythm. Viral myocarditis with complete heart block can be treated conservatively and observed for recovery of conduction abnormality as in our case.
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Lodh et al. (2012) studied this question.
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