Arrhythmias directly attributable to the leukemic process per se are unusual in pediatric practice.1.2 An extensive review of literature has revealed just one such case, reported by Habel in 1974.3 The present communication documents the occurrence of complete heart block in an 8-year-old girl under author's care at the Snowdon Hospital, Simla, India.
Report of a Case—This young girl had a two-day history of severe epistaxis and progressively increasing respiratory difficulty. Physical examination revealed a well-nourished child (weight, 25.5 kg; height, 126 cm) with severe pallor and dyspnea. There were widespread petechial spots. Her pulse was irregular, with a rate of 56 beats per minute, and blood pressure was 90/50 mm Hg. The apex beat was displaced about 2 cm outside the midclavicular line and a soft systolic hemic murmur could be heard all over the precordium, with maximum intensity over the mitral area. The spleen was