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Commotio Cordis presenting as a temporary complete atrioventricular block in a 2-year-old girl with congenitally corrected transposition of the great arteries.

Abstract
This report describes a 2-year-old girl with congenitally corrected transposition of the great arteries (ccTGA) who presented with transient complete atrioventricular (AV) block after a mild chest blow. Running around the house with her older sister, she fell to the floor. Her sister also fell and landed on her. The girl became cyanotic and pale and experienced a transient loss of consciousness. At arrival to the emergency department, she had regained consciousness, but she remained pale. An electrocardiogram (ECG) demonstrated complete AV block with a heart rate of 78 beats per minute (bpm). The ECG after admission showed a Wenckebach-type second-degree AV block. Day 2 after admission, a 12-lead ECG showed significant ST and T-wave abnormalities in the precordial leads, but the girl had no chest pain and a normal physical examination. Echocardiography demonstrated normal contractility of the systemic right ventricle. The first-degree AV block and the ST and T-wave abnormalities on the 12-lead ECG improved gradually without abnormal Q-waves. This is the first report of ccTGA in which a transient complete AV block naturally recovered after a presentation with commotio cordis.
AuthorsShuhei Fujita, Taichi Nakamura, Uta Koura, Akiko Toga, Shihomi Ina, Hiroyuki Higashiyama, Takeshi Futatani, Shoetsu Shimura, Noboru Igarashi, Kiyoshi Hatasaki
JournalPediatric cardiology (Pediatr Cardiol) Vol. 32 Issue 7 Pg. 1043-7 (Oct 2011) ISSN: 1432-1971 [Electronic] United States
PMID21796443 (Publication Type: Case Reports, Journal Article)
Topics
  • Accidental Falls
  • Child, Preschool
  • Commotio Cordis (complications, diagnosis)
  • Congenitally Corrected Transposition of the Great Arteries
  • Diagnosis, Differential
  • Echocardiography
  • Electrocardiography
  • Female
  • Follow-Up Studies
  • Heart Block (diagnosis, etiology)
  • Humans
  • Radiography, Thoracic
  • Remission, Spontaneous
  • Transposition of Great Vessels (complications, diagnosis)

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