Atrioventricular Block in Children

Introduction to Atrioventricular Block in Children

Atrioventricular (AV) block in children is a cardiac conduction disorder characterized by impaired electrical signal transmission from the atria to the ventricles. This condition can range from mild and asymptomatic to severe and life-threatening, depending on the degree of block and underlying cause. AV block in the pediatric population presents unique challenges in diagnosis and management due to its varied etiology and potential impact on growth and development.

The incidence of AV block in children is relatively low, with congenital complete heart block occurring in approximately 1 in 15,000 to 1 in 20,000 live births. Acquired AV block can occur at any age and may be associated with various conditions or interventions.



Objective QnA: Atrioventricular Block in Children
  1. What is the primary function of the atrioventricular (AV) node?
    To delay electrical impulses between the atria and ventricles
  2. Which type of AV block is characterized by a prolonged PR interval?
    First-degree AV block
  3. In second-degree AV block type I (Wenckebach), what happens to the PR interval?
    It progressively lengthens until a QRS complex is dropped
  4. What is the hallmark of second-degree AV block type II (Mobitz II)?
    Intermittent failure of AV conduction without PR prolongation
  5. Which type of AV block is most commonly associated with congenital heart defects?
    Third-degree (complete) AV block
  6. What is the most common cause of acquired complete AV block in children?
    Surgical intervention for congenital heart disease
  7. Which autoimmune condition is associated with congenital complete AV block?
    Neonatal lupus erythematosus
  8. What is the primary treatment for symptomatic complete AV block in children?
    Permanent pacemaker implantation
  9. Which medication can cause AV block as a side effect in children?
    Beta-blockers
  10. What is the typical heart rate in a child with complete AV block?
    40-80 beats per minute
  11. Which imaging modality is most useful for diagnosing the etiology of AV block in children?
    Echocardiography
  12. What percentage of children with congenital complete AV block require pacemaker implantation by adulthood?
    Approximately 65%
  13. Which electrolyte imbalance can exacerbate AV block?
    Hyperkalemia
  14. What is the most common symptom of AV block in children?
    Fatigue
  15. Which viral infection is associated with transient AV block in children?
    Lyme disease
  16. What is the Stokes-Adams attack in the context of AV block?
    Sudden loss of consciousness due to ventricular asystole
  17. Which congenital heart defect is most commonly associated with AV block?
    L-transposition of the great arteries
  18. What is the role of exercise testing in children with AV block?
    To assess chronotropic competence and exercise-induced higher degree block
  19. Which type of AV block is most likely to progress to complete heart block?
    Second-degree AV block type II (Mobitz II)
  20. What is the typical management approach for asymptomatic first-degree AV block in children?
    Observation without intervention
  21. Which cardiac structure is most commonly affected in congenital AV block?
    The AV node
  22. What is the role of temporary pacing in managing AV block in children?
    To stabilize patients with symptomatic bradycardia before permanent pacemaker implantation
  23. Which surgical procedure for congenital heart disease carries the highest risk of postoperative AV block?
    Ventricular septal defect closure
  24. What is the most common mode of pacing used in children with complete AV block?
    DDD (dual chamber pacing and sensing)
  25. Which diagnostic test is essential for differentiating between second-degree AV block type I and type II?
    12-lead ECG
  26. What is the significance of a wide QRS complex in a child with complete AV block?
    It indicates a lower (ventricular) escape rhythm
  27. Which medication can be used to temporarily increase heart rate in symptomatic AV block?
    Atropine
  28. What is the recommended follow-up interval for children with asymptomatic second-degree AV block?
    Every 3-6 months
  29. Which conduction system disease is often associated with familial AV block in children?
    Progressive cardiac conduction disease (Lenègre disease)
  30. What is the primary goal of managing AV block in children?
    To prevent symptoms and sudden cardiac death


Disclaimer

The notes provided on Pediatime are generated from online resources and AI sources and have been carefully checked for accuracy. However, these notes are not intended to replace standard textbooks. They are designed to serve as a quick review and revision tool for medical students and professionals, and to aid in theory exam preparation. For comprehensive learning, please refer to recommended textbooks and guidelines.



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