RECENT REVIEWS of congenital complete atrioventricular heart block in infancy and childhood1,2 have drawn attention to the fact that loss of consciousness due to sudden changes in cardiac rate or rhythm accompanied by markedly reduced cardiac output (Stokes-Adams syndrome) occurs more frequently in this condition than has been appreciated in the past. The association of these episodes with complete atrioventricular block produced by cardiac surgery is well established.3,4 However, the occurrence of this syndrome in previously well children who have not undergone heart surgery is so infrequent that many pediatricians are not well acquainted with its clinical features and with modern techniques of treatment. Experience with two children presenting pediatric emergencies of this nature prompts us to report their cases and to review current methods of management.
Report of Cases
Case 1.—A 4-year-old girl, was well until five days before her admission to the Palo Alto-Stanford Medical Center,