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Adams-Stokes attack as the first symptom of acute rheumatic fever: report of an adolescent case and review of the literature.
[acute rheumatic fever]
Acquired
complete
heart
block
,
in
pediatric
age
is
mainly
the
results
of
direct
injury
to
conduction
tissue
during
cardiac
surgery
or
cardiac
catheterisation
.
It
can
also
be
observed
in
different
clinical
settings
as
infectious
diseases
,
neoplasia
,
and
inflammatory
diseases
.
It
has
a
wide
range
of
presentation
and
in
some
settings
it
can
appear
a
dramatic
event
.
Although
a
rare
finding
during
acute
rheumatic
fever
,
with
a
transient
course
,
it
may
need
a
specific
and
intensive
treatment
.
We
report
the
case
of
an
Adams-
Stokes
attack
in
an
adolescent
with
acute
rheumatic
carditis
and
complete
atrio-
ventricular
block
.
The
attack
was
the
first
symptom
of
carditis
.
We
reviewed
the
literature
and
could
find
25
cases
of
complete
atrio-
ventricular
block
due
to
rheumatic
fever
.
Ten
of
the
25
patients
experienced
an
Adams-
Stokes
attack
.
Nineteen
of
the
25
patients
were
certainly
in
the
pediatric
age
group
.
Seven
of
the
19
pediatric
cases
experienced
an
Adams-
Stokes
attack
.
In
16
/
25
cases
,
the
duration
of
the
atrio-
ventricular
block
was
reported
:
it
lasted
from
a
few
minutes
to
ten
days
.
Pacemaker
implantation
was
necessary
in
7
cases
.
Rheumatic
fever
must
be
kept
in
mind
in
the
diagnostic
work-up
of
patients
with
acquired
complete
atrio-
ventricular
block
,
particularly
when
it
occurs
in
pediatric
patients
.
The
insertion
of
a
temporary
pacemaker
should
be
considered
when
complete
atrio-
ventricular
block
determines
Adams-
Stokes
attacks
.
Complete
heart
block
during
acute
rheumatic
fever
is
rare
and
is
usually
transient
.
Along
with
endocarditis
,
myocarditis
and
pericarditis
,
complete
atrio-
ventricular
block
has
been
recognized
,
rarely
,
during
the
course
of
acute
rheumatic
carditis
.
Diseases
Validation
Diseases presenting
"neoplasia"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
aniridia
carcinoma of the gallbladder
cholangiocarcinoma
cowden syndrome
cushing syndrome
cutaneous mastocytosis
dedifferentiated liposarcoma
dentin dysplasia
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
familial hypocalciuric hypercalcemia
hodgkin lymphoma, classical
liposarcoma
lymphangioleiomyomatosis
neuralgic amyotrophy
oligodontia
oral submucous fibrosis
pleomorphic liposarcoma
primary effusion lymphoma
pyomyositis
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
werner syndrome
wolf-hirschhorn syndrome
This symptom has already been validated