Congenital complete heart block and spinal anaesthesia for caesarean section

Congenital complete heart block could be absolutely asymptomatic. Increased awareness of suspecting an atrioventricular heart block in patients with slow heart rate and electrocardiograph examination will ensure recognition of this problem. The possibility of sudden cardiac death in these patients should not be forgotten. The goal in the peri-operative anaesthetic management is to preserve the heart rate and maintain haemodynamic stability. Herein, we present a case of congenital complete heart block posted for elective caesarean section for an obstetric indication. We would like to highlight the advantage of bupivacaine–fentanyl combination in maintaining haemodynamic stability and peri-operative heart rate control with temporary pacemaker.