Complex cyanotic congenital heart disease presenting as congenital heart block in a Nigerian infant: case report and literature review
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Abstract
Background: The prevalence of cyanotic congenital heart diseases (CCHD) varies world wide. It accounts for a third of all congenital heart diseases. The common CCHD includes Tetralogy of Fallot(TOF), transposition of the great arteries (TGA), total anomalous pulmonary venous return (TAPVR), truncus arteriosus, and tricuspid atresia (TA). Less common variants include Ebstein’s anomaly, Hypoplastic left heart syndrome, pulmonary atresia, and single ventricle. Children of all ages can be are affected. The commonest presentation is cyanosis. Bradycardia and/or congenital heart block are rare presentations and mostly occur in the presence of an associated congenital atrioventricular block.
Case report: We report a case of a 3-month-old female presenting with congenital heart block and bradycardia at 3 months of age and found to have complex cyanotic congenital heart disease on echocardiography.
Conclusion: An infant presenting with bradycardia clinically should be screened for congenital heart defect as bradycardia may be an ominous sign of serious underlying cardiac defect.
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Daniel Bernstein In: R.M. Kliegman, (editor). Cyanotic Congenital Heart Disease: Evaluation of the Critically Ill Neonate with Cyanosis and Respiratory Distress. Nelson Textbook of Paediatrics. 20th ed. Philadelphia: Elsevier. 2016; 2211–2235.
Van der Linde D, Konings EE, Slager MA, Witsenburg M, Helbing WA, et al. Birth prevalence of congenital heart disease worldwide: a systemic review and meta-analysis. J Am Coll Cardiol. 2011; 58: 22417. PubMed: https://pubmed.ncbi.nlm.nih.gov/22078432/
Gorini F, Chiappa E, Gargani L, Picano E. Potential effects of environmental chemical contamination in congenital heart disease. Pediatr Cardiol. 2014; 35: 559-568. PubMed: https://pubmed.ncbi.nlm.nih.gov/24452958/
Snijder CA, Vlot IJ, Burdorf A, Obermann-Borst SA, Helbing WA, et al. Congenital heart defects and parental occupational exposure to chemicals. Hum Reprod. 2012; 27: 1510-1517. PubMed: https://pubmed.ncbi.nlm.nih.gov/22357765/
Richards AA, Garg V. Genetics of Congenital Heart Disease. Curr Cardiol Rev. 2010; 6: 91-97. PubMed: https://pubmed.ncbi.nlm.nih.gov/21532774/
Shawky RM, Elsayed SM, Zaki ME, et al. Consanguinity and its relevant to clinical genetics. Egyptian J Med Human Genet. 2013; 14: 157-164.
Animasahun B, Madise-Wobo A, Kusimo O. Cyanotic congenital heart diseases among Nigerian children. Cardiovascu Diagnosis Ther. 2017; 7: 389-396. PubMed: https://pubmed.ncbi.nlm.nih.gov/28890875/
Otaigbe BE, Tabansi PN. Congenital heart disease in the Niger Delta region of Nigeria: a four-year prospective echocardiographic analysis. Cardiovasc J Afr. 2014; 25: 265-268. PubMed: https://pubmed.ncbi.nlm.nih.gov/25388927/
Ibadin MO, Sadoh WE, Osarogiagbon W. Congenital heart diseases at the University of Benin Teaching Hospital. Niger J Paediatr. 2005; 32: 29-32.
Sani MU, Mukhtar-Yola M, Karaye KM. Spectrum of Congenital Heart Disease in a Tropical Environment: An Echocardiography Stud. J Natl Med Assoc. 2007; 99: 665-669. PubMed: https://pubmed.ncbi.nlm.nih.gov/17595936/
Sadoh WE, Uzodimma CC, Daniels Q. Congenital Heart Disease in Nigerian Children. World J Pediatr Congenit Heart Surg. 2013; 4: 172-176. PubMed: https://pubmed.ncbi.nlm.nih.gov/23799730/
Nkoke C, Wawo E, Mfeukeu L, Makamte L, Edie S, et al. Complete congenital heart block in a neonate with a complex cyanotic congenital heart defect in Africa. Cardiovasc Diagno Ther. 2016; 6: 78-82. PubMed: https://pubmed.ncbi.nlm.nih.gov/27904846/
Asani M, Aliyu I, Kabir H. Profile of congenital heart defects among children at Aminu Kano. Teaching Hospital, Kano, Nigeria. J Med Trop. 2013; 15: 131-134.
Chinawa JM, Eze JC, Obi I, Arodiwe I, Ujunwa F, et al. Synopsis of congenital cardiac disease among children attending University of Nigeria Teaching Hospital Ituku Ozalla, Enugu. BMC Res Notes. 2013; 6: 475. PubMed: https://pubmed.ncbi.nlm.nih.gov/24252233/
Ashraf AT, Marwa AA, Mohamed AM. Clinical profile of cyanotic congenital heart disease in neonatal intensive care unit at Sohag University Hospital, Upper Egypt. Egyptian J Med Human Genet. 2017; 18: 47-51.
Rosenthal E. Classification of congenital complete heart block: autoantibody-associated or isolated? Lupus 2003; 12: 425-426. PubMed: https://pubmed.ncbi.nlm.nih.gov/12873042/
Lazzerini PE, Capecchi PL, Guideri F, Acampa M, Galeazzi M, et al. Connective tissue diseases and cardiac rhythm disorders: an overview. Autoimmun Rev. 2006; 5: 306-313. PubMed: https://pubmed.ncbi.nlm.nih.gov/16782554/
Jaeggi ET, Hamilton RM, Silverman ED, Zamora SA, Hornberger LK. Outcome of children with fetal, neonatal or childhood diagnosis of isolated congenital atrioventricular block. A single institution’s experience of 30 years. J Am Coll Cardiol. 2002; 39: 130-137. PubMed: https://pubmed.ncbi.nlm.nih.gov/11755298/
Kertesz NJ, Fenrich AL, Friedman RA. Congenital complete atrioventricular block. Tex Heart Inst J. 1997; 24: 301-307. PubMed: https://pubmed.ncbi.nlm.nih.gov/9456483/
Namuyonga J, Lwabi P, Lubega S. Congenital heart block in a ugandan infant. Cardiovasc J Afr. 2015; 26: 28. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5119992/
Hoffman JIE, Kaplan S. The incidence of congenital heart disease. J Am Coll Cardiol. 2002; 39: 1890-900. PubMed: https://pubmed.ncbi.nlm.nih.gov/12084585/
Friedman D, Duncanson Lj, Glickstein J, et al. A review of congenital heart block. Images Paediatr Cardiol. 2003; 5: 36-48. PubMed: https://pubmed.ncbi.nlm.nih.gov/22368629/