Patient education: Heart block in children (The Basics)

What is heart block? — 

This is a condition that affects the heartbeat.

Heart block in children can be mild or serious. Mild types of heart block can cause a child's heart to beat more slowly than normal or to skip beats. More serious types can cause a child's heart rate to be dangerously low. Without emergency treatment, serious heart block can be fatal.

What causes heart block in children? — 

Normally, the heart has a built-in electrical system that makes it beat (figure 1). Heart block happens when there is a slowing or blockage of the electrical signal from the upper part of the heart to the lower part that pumps the blood. This can cause the heart rate to be slower than normal.

Heart block can be caused by:

●"Congenital heart defects" – These are problems with the heart that happened before the child was born. Congenital means the person was born with the condition.

●"Neonatal lupus" – This is an autoimmune disease. It can happen when a mother has certain types of antibodies (proteins in the blood) that are passed on to the baby.

●Surgery for another congenital heart defect

●Other heart problems, diseases, or injuries

What are the symptoms of heart block? — 

The symptoms depend on the type of heart block. There are 3 types:

●First-degree – This is the mildest type and often causes no symptoms.

●Second-degree – This is more serious than first-degree. Children with second-degree heart block might have symptoms. Symptoms can include:

•Fainting

•Feeling dizzy

•Feeling tired

●Third-degree (also called "complete" heart block) – This is the most serious typ. It can cause the same symptoms as those of second-degree, but they are more severe. Third-degree heart block can be life-threatening.

Will my child need tests? — 

Yes. Your child will have 1 or more of these:

●Electrocardiogram ("ECG") – This measures the electrical activity in the heart.

●Holter monitor – This is a small, portable machine the child wears that records all their heart's electrical activity over 1 or 2 days.

●Echocardiogram – This uses sound waves to create a picture of the heart as it beats. It might be used if your child has a history of passing out, or if the ECG or Holter monitor test results are abnormal. It checks to see if there are any structural heart problems (congenital heart defects), and it tests how well the heart is pumping.

How is heart block treated? — 

Treatment depends on the type of heart block and the child's symptoms.

Often, children who have first-degree heart block do not need treatment. But children who have third-degree heart block and some who have second-degree heart block need a pacemaker. This is a device that goes under the skin near the heart. It sends electrical signals to the heart that help it beat normally.

More on this topic

Patient education: Overview of heart arrhythmias (The Basics)
Patient education: ECG and stress test (The Basics)
Patient education: Ambulatory heart monitoring (The Basics)
Patient education: Echocardiogram (The Basics)
Patient education: Pacemakers (The Basics)
Patient education: Heart block in adults (The Basics)

Patient education: Pacemakers (Beyond the Basics)