title: 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.
authors.affiliation: Department of Pediatric, Toyama Prefectural Central Hospital, 2-2-78 Nishinagae-cho, Toyama-shi, Toyama 930-8550, Japan. pediatrics_car@yahoo.co.jp
authors.forename: Shuhei
authors.initials: S
authors.lastname: Fujita
authors.forename: Taichi
authors.initials: T
authors.lastname: Nakamura
authors.forename: Uta
authors.initials: U
authors.lastname: Koura
authors.forename: Akiko
authors.initials: A
authors.lastname: Toga
authors.forename: Shihomi
authors.initials: S
authors.lastname: Ina
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Higashiyama
authors.forename: Takeshi
authors.initials: T
authors.lastname: Futatani
authors.forename: Shoetsu
authors.initials: S
authors.lastname: Shimura
authors.forename: Noboru
authors.initials: N
authors.lastname: Igarashi
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Hatasaki
mesh_terms: D000058:Accidental Falls; D002675:Child, Preschool; D056104:Commotio Cordis / Q000150:complications* / Q000175:diagnosis; D000080041:Congenitally Corrected Transposition of the Great Arteries; D003937:Diagnosis, Differential; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006327:Heart Block / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D013902:Radiography, Thoracic; D012075:Remission, Spontaneous; D014188:Transposition of Great Vessels / Q000150:complications* / Q000175:diagnosis