Karina Moreira Silva Ramos
Cacoal Regional Hospital, BrazilPresentation Title:
Complete atrioventricular block in a new born son of a mother with systemic lupus erythematosus: A case report
Abstract
This case report presents a newborn diagnosed at birth with complete Atrioventricular Block (AVB), born to a mother with Systemic Lupus Erythematosus (SLE). The infant showed severe bradycardia and signs of congestive heart failure, including dyspnea and cyanosis. An electrocardiogram confirmed complete absence of atrioventricular conduction, while echocardiography excluded structural heart disease. The findings suggested an autoimmune origin due to maternal autoantibody transfer. The mother, with longstanding SLE and prior cardiac abnormalities, reinforced this suspicion. Management involved successful implantation of a permanent pacemaker, which led to hemodynamic stabilization and marked clinical improvement. The postoperative course was uneventful, with ongoing follow-up to monitor pacemaker and cardiac function. This case underlines the importance of prenatal screening in mothers with SLE, particularly those with cardiac involvement. Early identification of maternal autoantibodies linked to fetal conduction disorders enables timely intervention and reduces neonatal complications. Given that total AVB in newborns can range from asymptomatic to severe heart failure, vigilant monitoring with ECG and echocardiography is essential in infants of mothers with SLE. Although pacemaker implantation is invasive, in this case it was crucial for survival and appropriate development. Therapeutic strategies should be individualized, based on symptom severity and AVB degree. The report also emphasizes a multidisciplinary approach involving pediatric cardiologists, obstetricians, and rheumatologists to optimize outcomes in neonates with AVB related to maternal SLE. Continued research is needed to clarify the pathogenesis and refine management of this rare but serious condition.
Biography
Karina Moreira Silva Ramos is a pediatric resident at the Cacoal Regional Hospital (2023–2026) in Rondônia. She has worked in pediatrics for over seven years, with experience in newborn care, children's emergency rooms, pediatric wards, and pediatric and neonatal intensive care units. During the pandemic, she was on the front lines at the São Francisco do Guaporé Regional Hospital, providing care to pediatric and adult patients. She holds a postgraduate degree in Pediatrics from IBCMED (São Paulo, 2021–2023) and is approved by the Brazilian Society of Pediatrics. She earned a Specialist Degree in Pediatrics (2025) and is completing her pediatric residency (2026). Currently, she works at the Hospital and Maternity Ward for Accident Injured People in Cacoal and in the Pediatric and Neonatal ICU at Cândido Rondon Hospital in Ji-Paraná. She conducts studies focused on neonatology, with an emphasis on the case report of a newborn diagnosed at birth with complete atrioventricular block (AVB) to a mother with systemic lupus erythematosus (SLE). Her mission is to promote humane pediatric care based on scientific evidence and collaborative research.
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