Autoimmune-Mediated Congenital Heart Block

Publication date: Available online 8 October 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Benjamin Wainwright, Rohit Bhan, Catherine Trad, Rebecca Cohen, Amit Saxena, Jill Buyon, Peter IzmirlyAbstractAutoimmune-mediated congenital heart block (CHB) is a severe manifestation of neonatal lupus in which conduction tissues of the fetal heart are damaged. This occurs due to passive transference of maternal Ro (SSA) and La (SSB) autoantibodies, and subsequent inflammation and fibrosis of the atrioventricular (AV) node. Notably, the disease manifests after the fetal heart has structurally developed, ruling out other anatomical abnormalities that could otherwise contribute to block of conduction. Complete AV block is irreversible and the most common manifestation of CHB, though other cardiac complications such as endocardial fibroelastosis (EFE), a dilated cardiomyopathy, or valvular insufficiency have been observed. In this review, we will detail the classification, prevalence, pathogenesis, and clinical management recommendations for autoimmune CHB.
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - Category: OBGYN Source Type: research