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Heart Block -- Child

Definition

The heart has two upper chambers called atria and two lower chambers called ventricles. Electrical signals move through special nerve bundles to the atria then to the ventricle. When the electrical signals pass through as expected the heart pumps rhythmically.

Heart block occurs when the electrical signals do not travel normally through the heart. The heart can still pump blood but it beats much slower and less efficiently than normal. There are three types of heart block, ranging from mild to serious:

  • First-degree heart block—mildest form of heart block. Electrical signals reach all parts of the heart but move more slowly than normal. There are usually no symptoms, and heartbeat is normal.
  • Second-degree heart block—some of the electrical signals are not reaching the ventricles. This means sometimes the ventricles do not pump when they should.
  • Third-degree, or complete, heart block—most serious type of heart block. No electrical signals are able to reach the ventricles. Cells in the ventricles act as a back up and create their own electrical signals. This allows the ventricles to keep pumping but it is slower and out of rhythm with the rest of the heart. .
Anatomy of the Heart
IMAGE
Copyright © Nucleus Medical Media, Inc.

Causes

The causes of heart block in children may include:

  • Heart defect caused by genetics
  • Certain medications
  • Damage from surgery
  • Infections such as Lyme disease
  • Lupus in the mother
  • Electrolyte abnormalities
  • Autoimmune disorder

Risk Factors

Factors that may increase your child's chance of heart block include:

  • Previous heart problems like heart failure or heart attack
  • Heart valve problems
  • Certain medications
  • Exposure to toxic substances

Symptoms

Your child may not have any symptoms at all. If your child has any of the following, see the doctor.

  • Dizziness or light-headedness
  • Fainting (syncope)
  • Chest pain
  • Shortness of breath
  • Palpitations
  • Slow heart beat
  • Weakness or fatigue

Be aware that your child may feel these symptoms, but may not be able to tell you or know how to describe them. Watch out for signs, like:

  • Child has trouble keeping up with other children when playing
  • Child has “spells” during play and needs to sit down and rest

If your child has any of these symptoms, do not assume it is due to heart block. These symptoms may be caused by other, less serious health conditions.

Diagnosis

The doctor will ask about your child’s symptoms and medical history. A physical exam will be done.

An electrocardiogram (EKG) shows the heart's electrical activity. The doctor will be able to see a heart block with this test.

Treatment

The course of treatment will depend on the type of heart block. Generally, treatment is not needed for first-degree heart block.

A pacemaker may be needed for some cases of second-degree heart block and all cases of third-degree heart block. The pacemaker will send regular electrical signals to the heart. It will keep the heart beating in a more efficient rhythm.

If your child is diagnosed with heart block, follow the doctor's instructions.

Prevention

Unfortunately, there is no way to prevent heart block in your child.

Revision Information

  • Reviewer: Kari Kassir, MD
  • Review Date: 12/2013 -
  • Update Date: 01/14/2014 -
  • American College of Cardiology

    http://www.cardiosource.org

  • American Heart Association

    http://www.heart.org

  • Heart Rhythm Society

    http://www.hrsonline.org

  • Canadian Cardiovascular Society

    http://www.ccs.ca

  • Heart and Stroke Foundation of Canada

    http://www.heartandstroke.com

  • First-degree AV nodal block. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated June 14, 2013. Accessed June 20, 2013.

  • Heart block. Heart Rhythm Society website. Available at: http://www.hrsonline.org/Patient-Resources/Heart-Diseases-Disorders/Heart-Block. Accessed on June 20, 2013.

  • Second degree atrioventricular nodal block (non-Wenckebach). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated April 18, 2013. Accessed June 20, 2013.

  • Third degree atrioventricular nodal block. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated January 21, 2011. Accessed June 20, 2013.

  • University of California San Francisco. Heart block. UCSF Benioff Childrens’ Hospital website. Available at: http://www.ucsfchildrenshospital.org/conditions/heart%5Fblock/. Accessed on June 20, 2013.

  • What is heart block? National Heart, Lung and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/hb/. Accessed on June 20, 2013.