Second degree AV block physical examination: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Second degree AV block}} | {{Second degree AV block}} | ||
{{CMG}}; {{AE}} {{AEL}} | {{CMG}}; {{AE}} {{AEL}} {{sali}} | ||
==Overview== | ==Overview== | ||
Patients with second degree AV block are usually asymptomatic. However, patients with previous chronic cardiac condition may appear in a distress. In symptomatic patients, common physical examination findings include bradycardia, hypotension, and syncope. | [[Patients]] with second degree [[AV block]] are usually asymptomatic. However, [[patients]] with previous chronic [[cardiac]] [[condition]] may appear in a distress. In symptomatic [[patients]], common [[physical examination]] findings include [[bradycardia]], [[hypotension]], and [[syncope]]. [[Physical examination]] in [[patients]] with [[heart failure]] may include [[lung crackles]], [[jugular venous distension]], and [[peripheral edema]]. | ||
==Physical examination== | ==Physical examination== | ||
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=== Appearance of the patient === | === Appearance of the patient === | ||
* Patients with second degree AV block type I (Mobitz I) are usually asymptomatic.<ref name="pmid30586772">{{cite journal| author=Kusumoto FM, Schoenfeld MH, Barrett C, Edgerton JR, Ellenbogen KA, Gold MR | display-authors=etal| title=2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. | journal=Circulation | year= 2019 | volume= 140 | issue= 8 | pages= e382-e482 | pmid=30586772 | doi=10.1161/CIR.0000000000000628 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30586772 }}</ref><ref name="pmid17303157">{{cite journal |vauthors=Bhargava K, Shrivastava S, Singh B, Wellens HJ |title=AV block. Which type and where? |journal=J Electrocardiol |volume=40 |issue=4 |pages=358–9 |date=October 2007 |pmid=17303157 |doi=10.1016/j.jelectrocard.2006.11.007 |url=}}</ref> | * [[Patients]] with [[second degree AV block type I]] (Mobitz I) are usually asymptomatic.<ref name="pmid30586772">{{cite journal| author=Kusumoto FM, Schoenfeld MH, Barrett C, Edgerton JR, Ellenbogen KA, Gold MR | display-authors=etal| title=2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. | journal=Circulation | year= 2019 | volume= 140 | issue= 8 | pages= e382-e482 | pmid=30586772 | doi=10.1161/CIR.0000000000000628 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30586772 }}</ref><ref name="pmid17303157">{{cite journal |vauthors=Bhargava K, Shrivastava S, Singh B, Wellens HJ |title=AV block. Which type and where? |journal=J Electrocardiol |volume=40 |issue=4 |pages=358–9 |date=October 2007 |pmid=17303157 |doi=10.1016/j.jelectrocard.2006.11.007 |url=}}</ref> | ||
* | * [[Patients]] with Mobitz II can appear [[asymptomatic]] as well. However, they may be progress to the more severe [[third-degree AV block]] in some cases. | ||
*[[ Patients]] may appear [[pale]] in cases of [[bradycardia]] with decreased [[cardiac output]].<ref name="pmid4701376">{{cite journal| author=Rosen KM, Dhingra RC, Loeb HS, Rahimtoola SH| title=Chronic heart block in adults. Clinical and electrophysiological observations. | journal=Arch Intern Med | year= 1973 | volume= 131 | issue= 5 | pages= 663-72 | pmid=4701376 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4701376 }}</ref> | |||
*Patients may appear pale in cases of bradycardia with decreased cardiac output.<ref name="pmid4701376">{{cite journal| author=Rosen KM, Dhingra RC, Loeb HS, Rahimtoola SH| title=Chronic heart block in adults. Clinical and electrophysiological observations. | journal=Arch Intern Med | year= 1973 | volume= 131 | issue= 5 | pages= 663-72 | pmid=4701376 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4701376 }}</ref> | |||
=== Vitals === | === Vitals === | ||
* Bradycardia with an irregular pulse | * [[Bradycardia]] with an irregular [[pulse]]<ref name="pmid699934">{{cite journal |vauthors=Schneider MD, Roller DH, Morganroth J, Josephson ME |title=The syndromes of familial atrioventricular block with sinus bradycardia: prognostic indices, electrophysiologic and histopathologic correlates |journal=Eur J Cardiol |volume=7 |issue=5-6 |pages=337–51 |date=July 1978 |pmid=699934 |doi= |url=}}</ref> | ||
* Lightheadedness | * Lightheadedness | ||
* Hypotension | * [[Hypotension]]<ref name="pmid27642736">{{cite journal |vauthors=Trappe HJ |title=[Consciousness disorders from cardiological view] |language=German |journal=Dtsch. Med. Wochenschr. |volume=141 |issue=19 |pages=1361–9 |date=September 2016 |pmid=27642736 |doi=10.1055/s-0042-103177 |url=}}</ref> | ||
* Syncope or presyncope | * [[Syncope]] or [[presyncope]] | ||
=== Neck === | === Neck === | ||
* Jugular venous distension | * [[Jugular venous distension]] | ||
=== Lungs === | === Lungs === | ||
* Bibasilar crackles in patients with exacerbated heart failure | * Bibasilar [[crackles]] in [[patients]] with exacerbated [[heart failure]] | ||
=== Extremities === | === Extremities === | ||
* Peripheral edema | * Peripheral [[edema]] in case of [[heart failure]] [[disease]] | ||
==References== | ==References== | ||
Latest revision as of 07:52, 11 July 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Elsaiey, MBBCH [2] Syed Musadiq Ali M.B.B.S.[3]
Overview
Patients with second degree AV block are usually asymptomatic. However, patients with previous chronic cardiac condition may appear in a distress. In symptomatic patients, common physical examination findings include bradycardia, hypotension, and syncope. Physical examination in patients with heart failure may include lung crackles, jugular venous distension, and peripheral edema.
Physical examination
Appearance of the patient
- Patients with second degree AV block type I (Mobitz I) are usually asymptomatic.[1][2]
- Patients with Mobitz II can appear asymptomatic as well. However, they may be progress to the more severe third-degree AV block in some cases.
- Patients may appear pale in cases of bradycardia with decreased cardiac output.[3]
Vitals
- Bradycardia with an irregular pulse[4]
- Lightheadedness
- Hypotension[5]
- Syncope or presyncope
Neck
Lungs
- Bibasilar crackles in patients with exacerbated heart failure
Extremities
- Peripheral edema in case of heart failure disease
References
- ↑ Kusumoto FM, Schoenfeld MH, Barrett C, Edgerton JR, Ellenbogen KA, Gold MR; et al. (2019). "2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society". Circulation. 140 (8): e382–e482. doi:10.1161/CIR.0000000000000628. PMID 30586772.
- ↑ Bhargava K, Shrivastava S, Singh B, Wellens HJ (October 2007). "AV block. Which type and where?". J Electrocardiol. 40 (4): 358–9. doi:10.1016/j.jelectrocard.2006.11.007. PMID 17303157.
- ↑ Rosen KM, Dhingra RC, Loeb HS, Rahimtoola SH (1973). "Chronic heart block in adults. Clinical and electrophysiological observations". Arch Intern Med. 131 (5): 663–72. PMID 4701376.
- ↑ Schneider MD, Roller DH, Morganroth J, Josephson ME (July 1978). "The syndromes of familial atrioventricular block with sinus bradycardia: prognostic indices, electrophysiologic and histopathologic correlates". Eur J Cardiol. 7 (5–6): 337–51. PMID 699934.
- ↑ Trappe HJ (September 2016). "[Consciousness disorders from cardiological view]". Dtsch. Med. Wochenschr. (in German). 141 (19): 1361–9. doi:10.1055/s-0042-103177. PMID 27642736.