A pacemaker at 11 years of age

Taking over the care of a 24 years old young lady the other day, she was admitted the night before due to collapse at home. She have had a pacemaker since she's 11. And looking at  her with her pony tail, she looked like a  6th grader.

Interventional Cardiology

There are a lot of heart problems that an adult can have in a life time, mostly as a result of one's lifestyle, can be inherited from one's parents, or from other factors that predisposes a person to heart diseases. With interventional cardiology, this focuses mainly with coronary artery blockages or better known as acute coronary syndrome (ACS). A person having a heart attack for instance can developed a deadly heart block, caused by a blocked artery. The patient's heart rate will drop so low, compromising the patient, and needing a temporary PACEMAKER. An adjunct that stimulates the heart to beat on demand or when it is required.

The solution can just be unblocking the artery, wait for the heart to recover, and normalises the heart's rhythm. SIMPLIFIED. If things gets worse, a permanent pacemaker will be needed. For life.

This can be a complete heart block, a side effect of a heart attack. 

A 10 year-old pacemaker, given to a patient after changing her device.

Congenital Complete Heart Block

This problem can occur even before birth till they became teenagers to young adult. For  the parents of these kids who develop this problem, there are no warning signs till they become symptomatic. Most complains are dizziness and collapse, where diagnostics will only show the abnormal heart rhythm.

My said patient was the only one in her family who have had the problem. Though a friend of mine have had the same problem, her symptoms started in her 50's. She have had cousins and an uncle who had the same problem in her mother side, all ended having pacemakers.

Congenital complete heart block is due to maternal disease or due to a congenital heart defect in the fetus that can manifest before or after birth. Research shows that isolated cases have occurred even with no structural defects, some from auto-immune antibodies in the mother that cross the placenta. 

With these in mind, some cases have had no aetiology in their occurrence. 

Prognosis

In our Heart Attack Centre, the Arrhythmia services is open 24 hours a day, where we receive patients from 16 years of age and above. I don't recall having younger patients than 16 as paediatrics go elsewhere. For these age, morbidity is lower compared to those patients that have not received any pacemakers. 

Research shows that patients' morbidity with this problem depends upon the age on when the symptoms manifest themselves, where the most vulnerable have the highest number of deaths. 

Insertion of pacemaker is recommended as the prognosis is much better due to less complications from their disease.

https://emedicine.medscape.com/article/894703-overview