Second degree AV block causes: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
 
(40 intermediate revisions by 7 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Second degree AV block}}
{{Second degree AV block}}
{{CMG}}; {{AE}} {{CZ}} {{MS}}
{{CMG}}; {{AE}} {{CZ}}; {{MS}}
<br>{{SK}}; AV block, atrioventricular block, heart block, Mobitz type I AV block, Mobitz type II AV block, Advanced second degree AV block,  (Wenckebach) AV block


==Overview==
==Overview==
 
Common causes of second degree [[AV block]] include acute [[myocardial ischemia]] or [[infarction]], [[infiltrative]] diseases, [[collagen vascular disease]], [[surgical trauma]], [[endocrine]] abnormalities, [[autonomic]] effects, [[neuromuscular ]] disorders, and [[medication]]s.
Atrioventricular (AV) block is defined as an interruption in the transmission of an impulse, either transient or permanent, from the atria to the ventricles due to an anatomic or functional impairment in the conduction system.  In second degree AV block, some atrial impulses fail to reach the ventricles.  Wenckebach described progressive delay between atrial and ventricular contraction and the eventual failure of an atrial beat to reach the ventricles.  Mobitz subsequently divided second degree AV block into two subtypes, as determined by the findings on the [[electrocardiogram]].  In Mobitz type I AV block, progressive PR interval prolongation precedes a non-conducted P wave. While in Mobitz type II AV block, the PR interval remains unchanged prior to a P wave that suddenly fails to conduct to the ventricles.


==Causes==
==Causes==
===Life Threatening Causes===
===Life Threatening Causes===
Life-threatening conditions  can result in death or permanent disability within 24 hours if left untreated.
Life-threatening conditions  can result in death or permanent disability within 24 hours if left untreated<ref name="pmid29493981">{{cite journal |vauthors=Mangi MA, Jones WM, Napier L |title= |journal= |volume= |issue= |pages= |date= |pmid=29493981 |doi= |url=}}</ref>.
* [[Acute myocardial infarction]]; especially inferior MIs
* [[Acute myocardial infarction]]<ref name="pmid30227965">{{cite journal |vauthors=Misumida N, Ogunbayo GO, Kim SM, Abdel-Latif A, Ziada KM, Elayi CS |title=Frequency and Significance of High-Degree Atrioventricular Block and Sinoatrial Node Dysfunction in Patients With Non-ST-Elevation Myocardial Infarction |journal=Am. J. Cardiol. |volume=122 |issue=10 |pages=1598–1603 |date=November 2018 |pmid=30227965 |doi=10.1016/j.amjcard.2018.08.001 |url=}}</ref><ref name="pmid23224264">{{cite journal |vauthors=Barold SS, Herweg B |title=Second-degree atrioventricular block revisited |journal=Herzschrittmacherther Elektrophysiol |volume=23 |issue=4 |pages=296–304 |date=December 2012 |pmid=23224264 |doi=10.1007/s00399-012-0240-8 |url=}}</ref>
* [[Acute rheumatic fever]]
* [[Acute rheumatic fever]]
* [[Bacterial endocarditis]]
* [[Bacterial endocarditis]]
* [[Myocarditis]]
* [[Myocarditis]]
* [[hypothermia|Severe hypothermia]]


===Common Causes===
===Common Causes===  
The most common causes of first degree heart block are an AV nodal disease, enhanced vagal tone (for example in athletes), [[myocarditis]], acute [[myocardial infarction]] (especially acute inferior MI), electrolyte disturbances and [[drugs]].  The drugs that most commonly cause first degree heart block are those that increase the refractory time of the [[AV node]], thereby slowing AV conduction. These include [[calcium channel blockers]], [[beta-blockers]],[[digitalis]],[[cardiac glycosides]] and anything that increases [[cholinergic]] activity such as [[cholinesterase inhibitor]]s.
* [[Acute rheumatic fever]]
* Normal variants
* [[Bacterial endocarditis]]<ref name="pmid27585419">{{cite journal |vauthors=Kamatani T, Akizuki A, Kondo S, Shirota T |title=Second-Degree Atrioventricular Block Occurring After Tooth Extraction |journal=Anesth Prog |volume=63 |issue=3 |pages=156–9 |date=Fall 2016 |pmid=27585419 |pmc=5011958 |doi=10.2344/15-00042.1 |url=}}</ref>
** [[PR prolongation]] can be found in 0.5% of healthy patients.
* [[aortic stenosis|Calcific aortic stenosis]]
** Transient AV block can occur with [[vagal maneuvers]].
* [[Digoxin]]
 
* [[Dilated cardiomyopathy]]
* Acute ST elevation MI - [[Second degree block]] in 3.5% to 10%.
* [[Diltiazem]]
** Inferior ST elevation [[MI]]: [[AV block]] is more common in patients with inferior [[MI]]s (1/3rd of patients).
* [[Vasovagal syncope#Cardioinhibitory Response|Enhanced vagal tone]]
*** In 90% of patients the inferior wall is supplied by the [[RCA]] which gives off a branch to the [[AV node]].
* [[HCM]]
*** As a rule the [[AV block]] is transient and normal function returns within a week of the acute episode.
* [[Hypertension]]
** Anterior ST elevation [[MI]]: [[AV block]] may be seen in up to 21%.
* [[Iatrogenic]] after surgical correction of [[VSD]], [[tetralogy of Fallot]], and [[endocardial cushion defect]]
*** Block is the result of damage to the interventricular septum supplied by the [[LAD]]
* [[ST elevation MI|Inferior ST elevation MI]]
*** There is damage to the bundle branches either in the form of bilateral bundle branch block or [[trifascicular block]].
* [[mitral valve sclerosis|Massive calcification of the mitral annulus]]
*** [[RBBB]], [[RBBB]] + [[LAHB]], [[RBBB]] + [[LPHB]] or [[LBBB]] often appear before the development of [[AV block]].
* [[Myocarditis]]
*** The PR is normal or minimally prolonged before the onset of [[second degree AV block]] or [[third degree AV block]].
* [[PR interval|Normal variants]]<ref name="pmid8445186">{{cite journal |vauthors=Wogan JM, Lowenstein SR, Gordon GS |title=Second-degree atrioventricular block: Mobitz type II |journal=J Emerg Med |volume=11 |issue=1 |pages=47–54 |date=1993 |pmid=8445186 |doi=10.1016/0736-4679(93)90009-v |url=}}</ref>
*** Although the [[AV block]] is usually transient, there is a relatively high incidence of recurrence or high-degree AV block after the acute event.
* [[chest trauma|Penetrating and non-penetrating trauma of the chest]]
*** In addition to [[ischemia]], [[fibrosis]] and [[calcification]] of the summit of the ventricular septum that involve the branching part of the bundle branches, may play a role in the genesis of the conduction defect.
* [[Lev's disease|Sclerodegenerative disease of the electrical conduction system]]
 
* [[Verapamil]]
* Degenerative diseases
* [[Beta blocker|β blockers]]
** Sclerodegenerative disease of the bundle branches first described by Lenegre
** The pathologic process is called idiopathic bilateral bundle branch fibrosis and the heart block is called primary heart block
** This is the most common cause of chronic [[AV block]] (46%)
** Lev described similar degenerative lesions, which he referred to as sclerosis of the left side of the cardiac skeleton. There is progressive fibrosis and calcification of the mitral annulus, the central fibrous body, the pars membranacea, the base of the aorta, and the summit of the muscular ventricular septum. Various portions of the [[His bundle]] or the bundle branches may be involved, resulting in [[AV block]].
 
* Hypertension
** Chronic [[AV block]] in patients with [[HTN]] is thought to be due to [[CAD]] or sclerosis of the left side of the cardiac skeleton exacerbated by[[hypertension]]
 
* Diseases of the myocardium
** [[Acute rheumatic fever]]: PR prolongation is a common (25 to 95% of cases) sign in patients with [[acute rheumatic fever]]
*** Usually transient, disappears when the patient recovers
** [[Dilated cardiomyopathy]] results in various degrees of heart block are seen in 15% of patients
** [[HCM]]: 3% of patients with [[HCM]] will develop heart block
 
* Valvular Heart Disease
** Calcific [[aortic stenosis]] may be accompanied by chronic partial or complete AV block
** There is an extension of the calcification to involve the main bundle or its bifurcation, resulting in degeneration and necrosis of the conduction tissue
** May also occur in rheumatic mitral valve disease, but is less common
** Occasionally, massive calcification of the mitral annulus as an aging process may cause [[AV block]]
** May also be seen in [[bacterial endocarditis]], especially of the [[aortic valve]]
** [[Ebstein's anomaly]]  may be associated with first-degree AV block.
 
* Drugs
** [[Digoxin]] is one of the most common causes of reversible [[AV block]]
*** The ventricular response rate is more rapid than that due to organic lesions, and increased automaticity of the AV junctional pacemaker may be responsible.
** [[Quinidine]] and [[Procainamide]] may produce slight prolongation of the PR
** [[Beta blocker|β blockers]] may cause [[AV block]]
** [[Diltiazem]] and [[verapamil]] may cause AV conduction delay and [[PR interval]] prolongation
 
* Congenital
** Occurs in the absence of other evidence of organic heart disease
** Site is usually proximal to the bifurcation of the [[His bundle]], most often in the [[AV node]]
** Narrow [[QRS]] with a rate > 40 beats per minute
** Frequently seen in those with corrected [[transposition of the great vessels]], and occasionally in [[ASD]]s and [[Ebstein's anomaly]]
 
* Trauma
** May be induced during open heart surgery in the area of AV conduction tissue
** Seen in patients operated on for the correction of [[VSD]], [[tetralogy of Fallot]], and [[endocardial cushion defect]].
** May be due to [[edema]], transient ischemia, or actual disruption of the conduction tissue. The block may therefore be permanent or transient.
** Also reported with both penetrating and non-penetrating trauma of the chest


===Causes by Organ System===
===Causes by Organ System===
{|style="width:80%; height:100px" border="1"
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | AV nodal disease, [[Myocarditis]], Acute [[myocardial infarction]] (especially acute inferior MI), [[Hypertension]], [[Acute rheumatic fever]], [[Dilated cardiomyopathy]], [[HCM]], [[Myocarditis]], [[Valvular heart disease]], [[Transposition of the great vessels]], [[ASD]]s, [[Ebstein's anomaly]], [[VSD]], [[Tetralogy of Fallot]], [[Endocardial cushion defect]]
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Acute myocardial infarction]], [[acute rheumatic fever]], [[ASD]], [[dilated cardiomyopathy]], [[Ebstein's anomaly]], [[Carotid sinus hypersensitivity|hypersensitive carotid sinus syndrome]], [[hypertension]], [[hypertrophic cardiomyopathy]], [[Lev's disease]], [[myocardial bridging]], [[myocarditis]], [[PR interval|normal variants]], [[Aortic valve replacement|post aortic valve  replacement]], [[catheter ablation|post catheter ablation for arrhythmias]], [[ventricular septal defect surgery|post closure of a ventricular septal defect]], [[mitral valve replacement|post mitral valve replacement]], [[tetralogy of Fallot]], [[endocardial cushion defect]], [[transposition of the great vessels]], [[valvular heart disease]], [[VSD]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
Line 91: Line 50:
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
| '''Drug Side Effect'''
|bgcolor="Beige"| [[Calcium channel blockers]], [[Beta-blockers]], [[Digitalis]], [[Cardiac glycosides]], [[Cholinesterase inhibitor]]s, [[Quinidine]],[[Procainamide]]
|bgcolor="Beige"| [[Amiodarone]], [[beta-blockers]], [[digitalis]], [[calcium channel blockers]], [[cholinesterase inhibitor|cholinesterase inhibitors]], [[disopyramide]], [[dofetilide]], [[dolasetron]], [[donepezil]], [[eslicarbazepine acetate]], [[fesoterodine]], [[fingolimod]], [[flecainide]], [[ibutilide]], [[lacosamide]], [[magnesium]], [[paliperidone]], [[pramipexole]], [[procainamide]], [[propafenone]], [[propoxyphene]], [[quinidine]], [[sotalol]], [[terodiline]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
Line 99: Line 58:
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
| '''Endocrine'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Hyperthyroidism]], [[myxedema]], [[periodic  paralysis|thyrotoxic periodic paralysis]]
|-  
|-  
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Environmental'''
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Hypothermia]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
Line 111: Line 70:
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Genetic'''
| '''Genetic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Emery-Dreifuss muscular dystrophy]], [[Fabry disease]], [[glycogenosis type 2b]], [[Neuromuscular disease|hereditary neuromuscular disease]], [[Kearns-Sayre syndrome]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
| '''Hematologic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Multiple myeloma]] [[Lymphoma]]<ref name="pmid27200273">{{cite journal |vauthors=Menicagli F, Lanza A, Sbrocca F, Baldi A, Spugnini EP |title=A case of advanced second-degree atrioventricular block in a ferret secondary to lymphoma |journal=Open Vet J |volume=6 |issue=1 |pages=68–70 |date=2016 |pmid=27200273 |pmc=4833871 |doi=10.4314/ovj.v6i1.10 |url=}}</ref>
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
| '''Iatrogenic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[aortic valve  replacement|Post aortic valve  replacement]], [[catheter ablation|post catheter ablation for  arrhythmias]], [[ventricular septal defect surgery|post closure of a  ventricular septal defect]], [[mitral valve  replacement|post mitral valve  replacement]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
| '''Infectious Disease'''
|bgcolor="Beige"| [[Acute rheumatic fever]], [[Chagas disease]], [[Diphtheria]], [[Lyme disease]], [[Myocarditis]]
|bgcolor="Beige"| [[Acute rheumatic fever]], [[Chagas disease]], [[diphtheria]], [[Lyme disease]], [[myocarditis]], [[neonatal lupus erythematosus]], [[protozoa|protozoal infection]], [[sarcoidosis]], [[SLE]], [[tuberculosis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal / Ortho'''
| '''Musculoskeletal / Ortho'''
|bgcolor="Beige"| [[Ankylosing spondylitis]], [[Muscular dystrophy]]
|bgcolor="Beige"| [[Ankylosing spondylitis]], [[Neuromuscular disease|hereditary neuromuscular disease]], [[Kearns-Sayre syndrome]], [[mitochondrial DNA|mitochondrial genome inherited conditions]], [[muscular dystrophy]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
| '''Neurologic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Vasovagal syncope#Cardioinhibitory Response|Enhanced vagal tone]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Nutritional / Metabolic'''
| '''Nutritional / Metabolic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Fabry disease]], [[glycogenosis type 2b]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
Line 143: Line 102:
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
| '''Oncologic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Multiple myeloma]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
| '''Opthalmologic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| No underlying causes
|-
|-
Line 163: Line 122:
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Renal / Electrolyte'''
| '''Renal / Electrolyte'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Hyperkalemia]], [[hypokalemia]]
|-
 
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Rheum / Immune / Allergy'''
| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"| [[Ankylosing spondylitis]], [[Dermatomyositis]], [[Scleroderma]], [[SLE]]
|bgcolor="Beige"| [[Ankylosing spondylitis]], [[dermatomyositis]], [[rheumatoid arthritis]], [[scleroderma]], [[SLE]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
Line 187: Line 146:
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
| '''Miscellaneous'''
|bgcolor="Beige"|  [[Amyloidosis]], Enhanced vagal tone (for example in athletes), Normal variants
|bgcolor="Beige"|  [[Amyloidosis]], [[degenerative diseases]]
|-
|-
|}
|}


===Causes in Alphabetical Order===
===Causes in Alphabetical Order===
*Acute [[myocardial infarction]] (especially acute inferior MI)
{{col-begin|width=80%}}
*[[Acute rheumatic fever]]
{{col-break|width=33%}}
*[[Amyloidosis]]
* [[Acute  myocardial infarction]]
*[[Ankylosing spondylitis]]
* [[Acute rheumatic fever]]
*[[ASD]]
* [[Amyloidosis]]
*AV nodal disease
* [[Ankylosing spondylitis]]
*[[Beta-blocker]]s
* [[ASD]]
*[[Calcium channel blocker]]s
* [[Bacterial endocarditis]]
*[[Cardiac glycosides]]
* [[Beta-blockers]]
*[[Chagas disease]]
* [[Calcific aortic stenosis]]
*[[Cholinesterase inhibitor]]s
* [[Calcium channel blockers]]
*[[Dermatomyositis]]
* [[Cardiac glycosides]]
*[[Digitalis]]
* [[Cardiac tumors]]
*[[Dilated cardiomyopathy]]
* [[Chagas disease]]
*[[Diphtheria]]
* [[Cholinesterase inhibitors]]
*[[Ebstein's anomaly]]
* [[Clonidine]]
*[[Endocardial cushion defect]]
* [[Degenerative diseases]]
*Enhanced vagal tone (for example in athletes)
* [[Dermatomyositis]]
*[[HCM]]
* [[Digitalis]]
*[[Hemochromatosis]]
* [[Digoxin]]
*[[Hypertension]]
* [[Dilated cardiomyopathy]]
*[[Lyme disease]]
* [[Diltiazem]]
*[[Muscular dystrophy]]
* [[Diphtheria]]
*[[Myocarditis]]
* [[Disopyramide]]
*Normal variants
* [[Dolasetron]]
*[[Procainamide]]
* [[Donepezil]]
*[[Quinidine]]
* [[Ebstein's anomaly]]
*[[Sarcoidosis]]
* [[Electrolyte disturbances]]
*[[Scleroderma]]
* [[Emery-Dreifuss muscular dystrophy]]
*[[SLE]]
* [[Endocarditis]]
*[[Tetralogy of Fallot]]
* [[vagus nerve|Enhanced vagal tone in athletes]]
*[[Transposition of the great vessels]]
{{col-break|width=33%}}
*[[Valvular heart disease]]
* [[Eslicarbazepine acetate]]
*[[VSD]]
* [[Fabry disease]]
* [[Fesoterodine]]
* [[Fingolimod]]
* [[Glycogenosis type 2b]]
* [[HCM]]
* [[Neuromuscular disease|Hereditary neuromuscular disease]]
* [[Hodgkin lymphoma]]
* [[Hyperkalaemia]]
* [[Carotid sinus hypersensitivity|Hypersensitive carotid  sinus syndrome]]
* [[Hyperthyroidism]]
* [[Hypokalaemia]]
* [[Hypothermia]]
* [[Ibutilide]]
* [[Ischemic heart disease]]
* [[Kearns-Sayre syndrome]]
* [[Labetalol]]
* [[Lacosamide]]
* [[Lanatoside C]]
* [[Lenegre's disease]]
* [[Lev's disease]]
* [[Lyme disease]]
* [[Mitochondrial DNA|Mitochondrial genome inherited conditions]]
* [[Multiple myeloma]]
* [[Muscular dystrophy]]
* [[Myocardial bridging]]
* [[Myocarditis]]
* [[Myotonic dystrophy]]
* [[Myxedema]]
{{col-break|width=33%}}
* [[Neonatal lupus erythematosus]]
* [[prolonged PR interval|Normal variants of PR prolongation]]
* [[Paliperidone]]
* [[aortic valve  replacement|Post aortic valve replacement]]
* [[catheter ablation|Post catheter ablation for  arrhythmias]]
* [[Ventricular septal defect surgery|Post closure of a  ventricular septal defect]]
* [[mitral valve  replacement|Post mitral valve  replacement]]
* [[Procainamide]]
* [[Propoxyphene]]
* [[Propranolol]]
* [[Protozoa|Protozoal infection]]
* [[Quinidine]]
* [[Quinine]]
* [[Rheumatic fever|Rheumatic mitral valve disease]]
* [[Sarcoidosis]]
* [[SLE]]
* [[Systemic sclerosis]]
* [[Terodiline]]
* [[Tetralogy of Fallot]]
* [[periodic  paralysis|Thyrotoxic periodic paralysis]]
* [[Tolterodine]]
* [[Transposition of the great vessels]]
* [[vagus nerve|Vagal maneuvers]]
* [[Valsalva maneuvers]]
* [[Valvular heart disease]]
* [[Verapamil]]
* [[VSD]]
* [[sex linkage|X-linked inherited  conditions]]
{{col-end}}
===Contraindicated medications===
{{MedCondContrAbs
 
|MedCond = Second degree AV block (except in [[patients]] with a functioning artificial [[pacemaker]])<ref name="pmid26115830">{{cite journal |vauthors=Brignole M, Deharo JC, Guieu R |title=Syncope and Idiopathic (Paroxysmal) AV Block |journal=Cardiol Clin |volume=33 |issue=3 |pages=441–7 |date=August 2015 |pmid=26115830 |doi=10.1016/j.ccl.2015.04.012 |url=}}</ref><ref name="pmid11229299">{{cite journal |vauthors=Kelkar PN |title=Atenolol induced high grade AV block |journal=J Assoc Physicians India |volume=46 |issue=8 |pages=748, 751 |date=August 1998 |pmid=11229299 |doi= |url=}}</ref>|Adenosine|Atenolol|Betaxolol|Bisoprolol|Brimonidine tartrate and Timolol maleate|Carteolol|Diltiazem|Disopyramide|Dronedarone|Fingolimod|Flecainide|Metoprolol|Mexiletine|Nadolol|Nebivolol|Penbutolol|Pindolol|Propranolol|Sotalol|Timolol|Labetalol}}<ref name="pmid15234417">{{cite journal |vauthors=Zeltser D, Justo D, Halkin A, Rosso R, Ish-Shalom M, Hochenberg M, Viskin S |title=Drug-induced atrioventricular block: prognosis after discontinuation of the culprit drug |journal=J. Am. Coll. Cardiol. |volume=44 |issue=1 |pages=105–8 |date=July 2004 |pmid=15234417 |doi=10.1016/j.jacc.2004.03.057 |url=}}</ref>


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


{{WikiDoc Help Menu}}
{{WikiDoc Sources}}
[[Category:Electrophysiology]]
[[Category:Cardiology]]
[[Category:Cardiology]]
[[Category:Disease]]
[[Category:Up-To-Date]]
[[Category:Up-To-Date]]
[[Category:Up-To-Date cardiology]]
[[Category:Up-To-Date cardiology]]
[[Category:Arrhythmia]]
[[Category:Arrhythmia]]
 
[[Category:Electrophysiology]]
[[Category:Disease]]
[[Category:Disease]]


[[Category:Primary care]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Latest revision as of 05:40, 12 July 2021

Second degree AV block Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Second degree AV block from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

EKG Examples

Chest X Ray

Echocardiography

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Second degree AV block causes On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

slides

Images

American Roentgen Ray Society Images of Second degree AV block causes

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Second degree AV block causes

CDC on Second degree AV block causes

Second degree AV block causes in the news

Blogs on Second degree AV block causes

Directions to Hospitals Treating Second degree AV block

Risk calculators and risk factors for Second degree AV block causes

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Mahmoud Sakr, M.D. [3]

Overview

Common causes of second degree AV block include acute myocardial ischemia or infarction, infiltrative diseases, collagen vascular disease, surgical trauma, endocrine abnormalities, autonomic effects, neuromuscular disorders, and medications.

Causes

Life Threatening Causes

Life-threatening conditions can result in death or permanent disability within 24 hours if left untreated[1].

Common Causes

Causes by Organ System

Cardiovascular Acute myocardial infarction, acute rheumatic fever, ASD, dilated cardiomyopathy, Ebstein's anomaly, hypersensitive carotid sinus syndrome, hypertension, hypertrophic cardiomyopathy, Lev's disease, myocardial bridging, myocarditis, normal variants, post aortic valve replacement, post catheter ablation for arrhythmias, post closure of a ventricular septal defect, post mitral valve replacement, tetralogy of Fallot, endocardial cushion defect, transposition of the great vessels, valvular heart disease, VSD
Chemical / poisoning No underlying causes
Dermatologic No underlying causes
Drug Side Effect Amiodarone, beta-blockers, digitalis, calcium channel blockers, cholinesterase inhibitors, disopyramide, dofetilide, dolasetron, donepezil, eslicarbazepine acetate, fesoterodine, fingolimod, flecainide, ibutilide, lacosamide, magnesium, paliperidone, pramipexole, procainamide, propafenone, propoxyphene, quinidine, sotalol, terodiline
Ear Nose Throat No underlying causes
Endocrine Hyperthyroidism, myxedema, thyrotoxic periodic paralysis
Environmental Hypothermia
Gastroenterologic Hemochromatosis
Genetic Emery-Dreifuss muscular dystrophy, Fabry disease, glycogenosis type 2b, hereditary neuromuscular disease, Kearns-Sayre syndrome
Hematologic Multiple myeloma Lymphoma[6]
Iatrogenic Post aortic valve replacement, post catheter ablation for arrhythmias, post closure of a ventricular septal defect, post mitral valve replacement
Infectious Disease Acute rheumatic fever, Chagas disease, diphtheria, Lyme disease, myocarditis, neonatal lupus erythematosus, protozoal infection, sarcoidosis, SLE, tuberculosis
Musculoskeletal / Ortho Ankylosing spondylitis, hereditary neuromuscular disease, Kearns-Sayre syndrome, mitochondrial genome inherited conditions, muscular dystrophy
Neurologic Enhanced vagal tone
Nutritional / Metabolic Fabry disease, glycogenosis type 2b
Obstetric/Gynecologic No underlying causes
Oncologic Multiple myeloma
Opthalmologic No underlying causes
Overdose / Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary Sarcoidosis
Renal / Electrolyte Hyperkalemia, hypokalemia
Rheum / Immune / Allergy Ankylosing spondylitis, dermatomyositis, rheumatoid arthritis, scleroderma, SLE
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Dental No underlying causes
Miscellaneous Amyloidosis, degenerative diseases

Causes in Alphabetical Order

Contraindicated medications

Second degree AV block (except in patients with a functioning artificial pacemaker)[7][8] is considered an absolute contraindication to the use of the following medications:

References

  1. ↑ Mangi MA, Jones WM, Napier L. PMID 29493981. Missing or empty |title= (help)
  2. ↑ Misumida N, Ogunbayo GO, Kim SM, Abdel-Latif A, Ziada KM, Elayi CS (November 2018). "Frequency and Significance of High-Degree Atrioventricular Block and Sinoatrial Node Dysfunction in Patients With Non-ST-Elevation Myocardial Infarction". Am. J. Cardiol. 122 (10): 1598–1603. doi:10.1016/j.amjcard.2018.08.001. PMID 30227965.
  3. ↑ Barold SS, Herweg B (December 2012). "Second-degree atrioventricular block revisited". Herzschrittmacherther Elektrophysiol. 23 (4): 296–304. doi:10.1007/s00399-012-0240-8. PMID 23224264.
  4. ↑ Kamatani T, Akizuki A, Kondo S, Shirota T (Fall 2016). "Second-Degree Atrioventricular Block Occurring After Tooth Extraction". Anesth Prog. 63 (3): 156–9. doi:10.2344/15-00042.1. PMC 5011958. PMID 27585419.
  5. ↑ Wogan JM, Lowenstein SR, Gordon GS (1993). "Second-degree atrioventricular block: Mobitz type II". J Emerg Med. 11 (1): 47–54. doi:10.1016/0736-4679(93)90009-v. PMID 8445186.
  6. ↑ Menicagli F, Lanza A, Sbrocca F, Baldi A, Spugnini EP (2016). "A case of advanced second-degree atrioventricular block in a ferret secondary to lymphoma". Open Vet J. 6 (1): 68–70. doi:10.4314/ovj.v6i1.10. PMC 4833871. PMID 27200273.
  7. ↑ Brignole M, Deharo JC, Guieu R (August 2015). "Syncope and Idiopathic (Paroxysmal) AV Block". Cardiol Clin. 33 (3): 441–7. doi:10.1016/j.ccl.2015.04.012. PMID 26115830.
  8. ↑ Kelkar PN (August 1998). "Atenolol induced high grade AV block". J Assoc Physicians India. 46 (8): 748, 751. PMID 11229299.
  9. ↑ Zeltser D, Justo D, Halkin A, Rosso R, Ish-Shalom M, Hochenberg M, Viskin S (July 2004). "Drug-induced atrioventricular block: prognosis after discontinuation of the culprit drug". J. Am. Coll. Cardiol. 44 (1): 105–8. doi:10.1016/j.jacc.2004.03.057. PMID 15234417.


Template:WikiDoc Sources

Retrieved from "https://www.wikidoc.org/index.php?title=Second_degree_AV_block_causes&oldid=1706508"