Heart block (patient information): Difference between revisions
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'''For the WikiDoc page for | __NOTOC__ | ||
{{ | '''For the WikiDoc page for Heart block, click [[Heart block|here]]''' | ||
{{CMG}}; | |||
'''For the WikiDoc page for Sinoatrial arrest, click [[Sinoatrial arrest|here]]''' | |||
'''For the WikiDoc page for Atrioventricular block, click [[Atrioventricular block|here]]''' | |||
'''For the WikiDoc page for First degree heart block, click [[First degree heart block|here]]''' | |||
'''For the WikiDoc page for Second degree heart block, click [[Second degree heart block|here]]''' | |||
'''For the WikiDoc page for Third degree heart block, click [[Third degree heart block|here]]''' | |||
'''For the WikiDoc page for Bundle branch block, click [[Bundle branch block|here]]''' | |||
'''For the WikiDoc page for Right bundle branch block, click [[Right bundle branch block|here]]''' | |||
'''For the WikiDoc page for Left bundle branch block, click [[Left bundle branch block|here]] | |||
'''For the WikiDoc page for Left anterior fascicular block, click [[Left anterior fascicular block|here]]''' | |||
'''For the WikiDoc page for Left posterior fascicular block, click [[Left posterior fascicular block|here]]''' | |||
'''For the WikiDoc page for Trifascicular block, click [[Trifascicular block|here]]''' | |||
'''For the WikiDoc page for Infra-Hisian block, click [[Infra-Hisian block|here]]''' | |||
'''For the WikiDoc page for Hemiblock, click [[Hemiblock|here]]''' | |||
{{Heart block (patient information)}} | |||
{{CMG}}; {{AE}} [[Varun Kumar]], M.B.B.S., {{EdzelCo}} | |||
==Overview== | ==Overview== | ||
Heart block is a problem that occurs with the heart's electrical system. This system controls the rate and rhythm of heartbeats. ("Rate" refers to the number of times your heart beats in a minute. "Rhythm" refers to the pattern of regular or irregular pulses produced when the heart beats over time.) | [[Heart block]] is a problem that occurs with the [[heart]]'s electrical system. This system controls the [[rate]] and [[rhythm]] of [[heartbeats]]. ("[[Rate]]" refers to the number of times your [[heart]] [[beats]] in a minute. "[[Rhythm]]" refers to the pattern of regular or irregular [[pulses]] produced when the [[heart]] [[beats]] over time.) | ||
With each heartbeat, an electrical signal spreads across the heart from the upper to the lower chambers. As it travels, the signal causes the heart to contract and pump blood. This process repeats with each new heartbeat. | With each [[heartbeat]], an electrical signal spreads across the [[heart]] from the upper to the lower [[chambers]]. As it travels, the signal causes the [[heart]] to [[contract]] and pump [[blood]]. This process repeats with each new [[heartbeat]]. | ||
Heart block occurs if the electrical signal is slowed or disrupted as it moves from the upper to the lower chambers of the heart. | [[Heart block]] occurs if the electrical signal is slowed or disrupted as it moves from the upper to the lower chambers of the [[heart]]. | ||
==What are the symptoms of | A serious condition will lead to stopping of the [[heartbeat]]. If left untreated, the [[patient]] may [[die]]. | ||
==What are the symptoms of Heart block?== | |||
Symptoms depend on the type of heart block you have. | Symptoms depend on the type of heart block you have. | ||
[[First-degree heart block]] rarely causes symptoms. | [[First-degree heart block]] rarely causes symptoms. | ||
Symptoms of second- and [[third-degree heart block]] include: | Symptoms of [[Second-degree heart block|second-]] and [[third-degree heart block]] include: | ||
*[[Chest pain]] | |||
*[[Dizziness]] | |||
*[[Fainting]] | |||
*[[Fatigue]] | |||
*[[Heart failure]] symptoms | |||
*[[Light-headedness]] | |||
*[[Pre-syncope]] | |||
*[[Shortness of breath]] | |||
*[[Syncope]] | |||
[[Third degree heart block]] are more life-threatening than [[second-degree heart block]]. | |||
==What causes | ==What causes Heart block?== | ||
Heart block has many causes. Some people are born with the disorder (congenital), while others develop it during their lifetimes (acquired). | [[Heart block]] has many causes. Some people are born with the [[disorder]] ([[congenital]]), while others develop it during their lifetimes ([[acquired]]) either from a [[disease]], [[medication]] or [[surgery]]. | ||
===Congenital Heart Block=== | ===Congenital Heart Block=== | ||
:*One form of [[congenital heart block]] occurs in [[babies]] whose [[mothers]] have [[autoimmune diseases]], such as [[Systemic lupus erythematosus (patient information)|lupus]]. People who have these diseases make [[proteins]] called [[antibodies]] that attack and damage the [[body]]'s [[tissues]] or [[cells]]. | |||
:* | :*In [[pregnant]] [[patients]], [[antibodies]] can cross the [[placenta]]. (The [[placenta]] is the [[organ]] that attaches the [[umbilical cord]] to the [[mother]]'s [[womb]].) These [[proteins]] can damage the [[baby]]'s [[heart]] and lead to [[congenital heart block]]. | ||
:*Congenital heart | :*[[Congenital heart defect]]s also may cause [[congenital heart block]]. These defects are problems with the [[heart]]'s structure that are present at [[birth]]. Often, [[doctors]] don't know what causes these defects. | ||
===Acquired Heart Block=== | ===Acquired Heart Block=== | ||
Many factors can cause acquired heart block. Examples include: | Many factors can cause [[acquired heart block]]. Examples include: | ||
:*Damage to the heart from a heart attack. This is the most common cause of acquired heart block. | :*Damage to the [[heart]] from a [[heart attack]]. This is the most common cause of [[acquired heart block]]. | ||
:*Coronary heart disease, also called coronary artery disease. | :*[[Coronary heart disease]], also called [[coronary artery disease]]. | ||
:*[[Myocarditis (patient information)|Myocarditis]], or inflammation of the heart muscle. | :*[[Myocarditis (patient information)|Myocarditis]], or [[inflammation]] of the [[heart]] [[muscle]]. | ||
:*Heart failure. | :*[[Heart failure]]. | ||
:*[[Rheumatic fever (patient information)|Rheumatic fever]]. | :*[[Rheumatic fever (patient information)|Rheumatic fever]]. | ||
:*[[Cardiomyopathy]], or heart muscle diseases. | :*[[Cardiomyopathy]], or [[heart]] [[muscle]] [[diseases]]. | ||
:*[[Sarcoidosis (patient information)| | :*[[Sarcoidosis (patient information)|Sarcoidosis]] | ||
:*Degenerative muscle disorders Lev's disease and Lenegre's disease. | :*[[Degenerative muscle disorders]] [[Lev's disease]] and [[Lenegre's disease]]. | ||
:*Certain types of surgery also may damage the heart's electrical system and lead to heart block. | :*Certain types of [[surgery]] also may damage the [[heart]]'s electrical system and lead to [[heart block]]. | ||
:*Exposure to toxic substances and taking certain | :*Exposure to [[toxic substances]] and taking certain [[medications]] - including [[digitalis]], [[beta blocker]]s, and [[calcium channel blocker]]s - also may cause [[heart block]]. [[Doctors]] closely watch people who are taking these [[medications]] for signs of problems. | ||
:*Some types of heart block have been linked to genetic mutations (changes in the | :*Some types of [[heart block]] have been linked to [[genetic mutations]] (changes in the [[gene]]s). | ||
:*An overly active vagus nerve also can cause heart block. You have one vagus nerve on each side of your body. These nerves run from your brain stem all the way to your | :*An overly active [[vagus nerve]] also can cause [[heart block]]. You have one [[vagus nerve]] on each side of your [[body]]. These [[nerves]] run from your [[brain stem]] all the way to your [[bdomen]]. Activity in the [[vagus nerve]] slows the [[heart rate]]. | ||
In some cases, acquired heart block may go away if the factor causing it is treated or resolved. For example, heart block that occurs after a heart attack or surgery may go away during recovery. | In some cases, [[acquired heart block]]may go away if the factor causing it is treated or resolved. For example, [[heart block]] that occurs after a [[heart attack]] or [[surgery]] may go away during [[recovery]]. | ||
Also, if a | Also, if a [[medication]] is causing [[heart block]], the [[disorder]] may go away if the [[medication]] is stopped or the [[dosage]] is lowered. Always talk with your [[doctor]] before you change the way you take your [[medications]]. | ||
==Who is at | ==Who is at highest risk?== | ||
The risk factors for congenital and acquired heart block are different. | The [[risk factors]] for congenital and acquired heart block are different. | ||
===Congenital Heart Block=== | ===Congenital Heart Block=== | ||
*If a pregnant | *If a [[pregnant]] [[patient]] has an [[autoimmune disease]], such as [[Systemic lupus erythematosus (patient information)|lupus]], her [[fetus]] is at risk for [[heart block]]. | ||
*[[Autoimmune disease]]s can cause the body to make proteins called [[antibodies]] that can cross the [[placenta]]. (The placenta is the organ that attaches the umbilical cord to the mother's womb.) These antibodies may damage the baby's heart and lead to [[congenital heart block]]. | *[[Autoimmune disease]]s can cause the [[body]] to make [[proteins]] called [[antibodies]] that can cross the [[placenta]]. (The [[placenta]] is the [[organ]] that attaches the [[umbilical cord]] to the [[mother]]'s [[womb]].) These [[antibodies]] may damage the [[baby]]'s [[heart]] and lead to [[congenital heart block]]. | ||
*[[Congenital heart defects]] also may result in congenital heart block. These defects are problems with the heart's structure that are present at birth. Most of the time, doctors don't know what causes these defects. | *[[Congenital heart defects]] also may result in [[congenital heart block]]. These defects are problems with the [[heart]]'s structure that are present at [[birth]]. Most of the time, [[doctors]] don't know what causes these defects. | ||
*Heredity may play a role in certain heart defects. For example, a parent who has a congenital heart defect may be more likely than other people to have a child with the condition. | *[[Heredity]] may play a role in certain [[heart defects]]. For example, a parent who has a [[congenital heart defect]] may be more likely than other people to have a [[child]] with the condition. | ||
===Acquired Heart Block=== | ===Acquired Heart Block=== | ||
*Acquired heart block can occur in people of any age. However, most types of the disorder are more common in older people. This is because many of the risk factors are more common in older people. | *[[Acquired heart block]] can occur in people of any [[age]]. However, most types of the [[disorder]] are more common in [[older]] people. This is because many of the risk factors are more common in older people. | ||
*People who have a history of [[heart disease]] or [[heart attacks]] are more likely to have heart block. Examples of heart disease that can lead to heart block include [[heart failure]], [[coronary heart disease]], and [[cardiomyopathy]] (heart muscle diseases). | *People who have a history of [[heart disease]] or [[heart attacks]] are more likely to have [[heart block]]. Examples of [[heart disease]] that can lead to [[heart block]] include [[heart failure]], [[coronary heart disease]], and [[cardiomyopathy]] ([[heart]] [[muscle]] [[diseases]]). | ||
*Other diseases also may raise the risk of heart block. These include [[Sarcoidosis (patient information)|sarcoidosis]] and the degenerative muscle disorders [[Lev's disease]] and [[Lenegre's disease]]. | *Other [[diseases]] also may raise the risk of [[heart block]]. These include [[Sarcoidosis (patient information)|sarcoidosis]] and the [[degenerative muscle disorders]] [[Lev's disease]] and [[Lenegre's disease]]. | ||
*Exposure to toxic substances or taking certain medicines, such as [[digitalis]], also can raise your risk of heart block. | *Exposure to [[toxic substances]] or taking certain [[medicines]], such as [[digitalis]], also can raise your risk of heart block. | ||
*Well-trained athletes and young people are at higher risk for [[first-degree heart block]] caused by an overly active [[vagus nerve]]. You have one vagus nerve on each side of your body. These nerves run from your brain stem all the way to your abdomen. Activity in the vagus nerve slows the heart rate. | *Well-trained athletes and young people are at higher risk for [[first-degree heart block]] caused by an overly active [[vagus nerve]]. You have one [[vagus nerve]] on each side of your body. These [[nerves]] run from your [[brain stem]] all the way to your [[abdomen]]. Activity in the [[vagus nerve]] slows the [[heart rate]]. | ||
==Diagnosis== | |||
[[Heart block]] may be [[diagnosed]] as part of a routine [[doctor]]'s visit or during an [[emergency situation]]. ([[Third-degree heart block]]) is often an [[emergency]].) Your [[doctor]] will diagnose [[heart block]] based on your [[family]] and [[medical histories]], a [[physical exam]], and results from tests such as: | |||
*[[Electrocardiogram]] ([[EKG]]): [[Doctors]] usually use a test called an [[EKG]] ([[electrocardiogram]]) to help diagnose [[heart block]]. An [[EKG]] shows how fast the [[heart]] is [[beating]] and its [[rhythm]] ([[steady]] or [[irregular]]). The test also records the strength and timing of [[electrical signals]] as they pass through each part of the [[heart]] | |||
*[[Holter monitors]]: A [[Holter monitor]] records the [[heart]]'s [[electrical signals]] for a full 24- or 48-hour period. You wear one while you do your normal daily activities. This allows the monitor to record your [[heart]] for longer than a standard [[EKG]]. | |||
*[[Event monitors]]: An event monitor is similar to a [[Holter monitor]]. You wear an event monitor while doing your normal activities. However, an event monitor only records your [[heart]]'s electrical activity at certain times while you're wearing it. | |||
*[[Electrophysiology]] study: For some cases of [[heart block]], [[doctors]] may do [[electrophysiology studies]] ([[EPS]]). During this test, a thin, flexible wire is passed through a [[vein]] in your [[groin]] (upper [[thigh]]) or [[arm]] to your [[heart]]. The wire records your [[heart]]'s [[electrical signals]]. | |||
==When to seek urgent medical care?== | ==When to seek urgent medical care?== | ||
If you are experiencing the above mentioned symptoms for the first time or are severe, call 9–1–1 or have someone drive you to the hospital emergency room. If you have milder symptoms, talk with your doctor right away to find out whether you need prompt treatment. | If you are experiencing the above-mentioned [[symptoms]] for the first time or are severe, call 9–1–1 or have someone drive you to the hospital [[emergency room]]. If you have milder [[symptoms]], talk with your [[doctor]] right away to find out whether you need prompt [[treatment]]. | ||
==Treatment options== | |||
[[Treatment]] depends on the type of [[heart block]] you have. [[First-degree heart block]] usually needs no [[treatment]]. | |||
If you have [[second-degree heart block]], you may need a [[pacemaker]]. A [[pacemaker]] is a small device that's placed under the [[skin]] of your [[chest]] or [[abdomen]]. This device uses [[electrical pulses]] to prompt the [[heart]] to [[beat]] at a normal [[rate]]. | |||
If you have [[third-degree heart block]], you will need a [[pacemaker]]. In an [[emergency]], a temporary [[pacemaker]] may be used until you can get a long-term device. Most people who have [[third-degree heart block]] need [[pacemakers]] for the rest of their lives. | |||
Some people who have [[third-degree congenital heart block]] do not need a [[pacemaker]] for many years. Others may need a [[pacemaker]] at a young [[age]] or during [[infancy]]. | |||
If | If a [[pregnant]] [[patient]] has an [[autoimmune disease]], such as [[lupus]], her [[fetus]] is at risk for [[heart block]]. If a [[heart block]] is detected in a [[fetus]], the [[mother]] may be given a [[medication]] to reduce the [[fetus]]' [[risk]] of developing serious [[heart block]]. | ||
Sometimes [[acquired heart block]] goes away if the factor causing it is treated or resolved. For example, [[heart block]] that occurs after a [[heart attack]] or [[surgery]] may go away during [[recovery]]. | |||
Also, if a [[medication]] is causing [[heart block]], the condition may go away if the [[medication]] is stopped or the [[dosage]] is lowered. Always talk with your [[doctor]] before you change the way you take your medicines. | |||
====Medications to avoid==== | |||
{{MedCondContrPI | |||
|MedCond = second-degree atrioventricular block and third-degree atrioventricular block|Amiodarone|Propafenone|Timolol}} | |||
==Where to find medical care for | ==Where to find medical care for Heart block?== | ||
[http://maps.google.com/maps?f=q&hl=en&geocode=&q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|Heart Block}}}}&sll=37.0625,-95.677068&sspn=65.008093,112.148438&ie=UTF8&ll=37.0625,-95.677068&spn=91.690419,149.414063&z=2&source=embed Directions to Hospitals Treating Heart Block] | [http://maps.google.com/maps?f=q&hl=en&geocode=&q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|Heart Block}}}}&sll=37.0625,-95.677068&sspn=65.008093,112.148438&ie=UTF8&ll=37.0625,-95.677068&spn=91.690419,149.414063&z=2&source=embed Directions to Hospitals Treating Heart Block] | ||
==What to expect (Outlook/Prognosis)?== | ==What to expect (Outlook/Prognosis)?== | ||
*First-degree heart block may not cause any symptoms or require treatment. | *[[First-degree heart block]] may not cause any [[symptoms]] or require [[treatment]]. | ||
*If you have second-degree heart block that doesn't require a pacemaker, talk with your doctor about keeping your heart healthy. Your doctor will tell you whether you need ongoing care for your condition. | *If you have [[second-degree heart block]] that doesn't require a [[pacemaker]], talk with your [[doctor]] about keeping your [[heart]] healthy. Your [[doctor]] will tell you whether you need ongoing care for your condition. | ||
*People who have third-degree heart block and some people who have second-degree heart block need pacemakers. This device uses electrical pulses to prompt the heart to beat at a normal rate. | *People who have [[third-degree heart block]] and some people who have [[second-degree heart block]] need [[pacemakers]]. This device uses [[electrical pulses]] to prompt the [[heart]] to [[beat]] at a normal [[rate]]. | ||
*If you have a pacemaker, you should take special care to avoid things that may interfere with it. Avoid close or prolonged contact with electrical devices and devices that have strong magnetic fields. These objects can keep your pacemaker from working properly. | *If you have a [[pacemaker]], you should take special care to avoid things that may interfere with it. Avoid close or prolonged contact with [[electrical devices]] and devices that have strong [[magnetic fields]]. These objects can keep your [[pacemaker]] from working properly. | ||
*Let all of your doctors, dentists, and medical technicians know that you have a pacemaker. You also should notify airport screeners. | *Let all of your [[doctors]], [[dentists]], and [[medical technicians]] know that you have a [[pacemaker]]. You also should notify airport screeners. | ||
*Your doctor can give you a card that states what kind of pacemaker you have. Carry this card in your wallet. You may want to consider wearing a medical ID bracelet or necklace that states that you have a pacemaker. | *Your [[doctor]] can give you a card that states what kind of [[pacemaker]] you have. Carry this card in your wallet. You may want to consider wearing a medical ID bracelet or necklace that states that you have a pacemaker. | ||
*Certain medical procedures can disrupt pacemakers. Examples include | *Certain [[medical procedures]] can disrupt [[pacemakers]]. Examples include [[magnetic resonance imaging]] ([[MRI]]), [[electrocauterization]] during [[surgery]], and [[shockwave]] [[lithotripsy]] to get rid of [[kidney stone]]s. | ||
*Your doctor may need to check your pacemaker several times a year to make sure it | *Your [[doctor]] may need to check your [[pacemaker]] several times a year to make sure it is working well. Some [[pacemakers]] must be checked in the [[doctor]]'s office, but others can be checked over the phone. | ||
*Ask your doctor about what types of physical activity are safe for you. A pacemaker usually | *Ask your [[doctor]] about what types of [[physical activity]] are safe for you. A [[pacemaker]] usually would not limit you from doing sports and [[physical activity]]. But you may need to avoid [[full-contact sports]], such as football, that can damage the [[pacemaker]]. | ||
==Possible complications== | ==Possible complications== | ||
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http://www.nhlbi.nih.gov/health/dci/Diseases/hb/hb_whatis.html | http://www.nhlbi.nih.gov/health/dci/Diseases/hb/hb_whatis.html | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
[[Category:Patient information]] | [[Category:Patient information]] | ||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category: | [[Category:Electrophysiology]] | ||
Latest revision as of 15:05, 14 July 2022
For the WikiDoc page for Heart block, click here
For the WikiDoc page for Sinoatrial arrest, click here
For the WikiDoc page for Atrioventricular block, click here
For the WikiDoc page for First degree heart block, click here
For the WikiDoc page for Second degree heart block, click here
For the WikiDoc page for Third degree heart block, click here
For the WikiDoc page for Bundle branch block, click here
For the WikiDoc page for Right bundle branch block, click here
For the WikiDoc page for Left bundle branch block, click here
For the WikiDoc page for Left anterior fascicular block, click here
For the WikiDoc page for Left posterior fascicular block, click here
For the WikiDoc page for Trifascicular block, click here
For the WikiDoc page for Infra-Hisian block, click here
For the WikiDoc page for Hemiblock, click here
|
Heart block |
|
Heart block On the Web |
|---|
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Varun Kumar, M.B.B.S., Edzel Lorraine Co, DMD, MD[2]
Overview
Heart block is a problem that occurs with the heart's electrical system. This system controls the rate and rhythm of heartbeats. ("Rate" refers to the number of times your heart beats in a minute. "Rhythm" refers to the pattern of regular or irregular pulses produced when the heart beats over time.)
With each heartbeat, an electrical signal spreads across the heart from the upper to the lower chambers. As it travels, the signal causes the heart to contract and pump blood. This process repeats with each new heartbeat.
Heart block occurs if the electrical signal is slowed or disrupted as it moves from the upper to the lower chambers of the heart.
A serious condition will lead to stopping of the heartbeat. If left untreated, the patient may die.
What are the symptoms of Heart block?
Symptoms depend on the type of heart block you have.
First-degree heart block rarely causes symptoms.
Symptoms of second- and third-degree heart block include:
- Chest pain
- Dizziness
- Fainting
- Fatigue
- Heart failure symptoms
- Light-headedness
- Pre-syncope
- Shortness of breath
- Syncope
Third degree heart block are more life-threatening than second-degree heart block.
What causes Heart block?
Heart block has many causes. Some people are born with the disorder (congenital), while others develop it during their lifetimes (acquired) either from a disease, medication or surgery.
Congenital Heart Block
- One form of congenital heart block occurs in babies whose mothers have autoimmune diseases, such as lupus. People who have these diseases make proteins called antibodies that attack and damage the body's tissues or cells.
- In pregnant patients, antibodies can cross the placenta. (The placenta is the organ that attaches the umbilical cord to the mother's womb.) These proteins can damage the baby's heart and lead to congenital heart block.
- Congenital heart defects also may cause congenital heart block. These defects are problems with the heart's structure that are present at birth. Often, doctors don't know what causes these defects.
Acquired Heart Block
Many factors can cause acquired heart block. Examples include:
- Damage to the heart from a heart attack. This is the most common cause of acquired heart block.
- Coronary heart disease, also called coronary artery disease.
- Myocarditis, or inflammation of the heart muscle.
- Heart failure.
- Rheumatic fever.
- Cardiomyopathy, or heart muscle diseases.
- Sarcoidosis
- Degenerative muscle disorders Lev's disease and Lenegre's disease.
- Certain types of surgery also may damage the heart's electrical system and lead to heart block.
- Exposure to toxic substances and taking certain medications - including digitalis, beta blockers, and calcium channel blockers - also may cause heart block. Doctors closely watch people who are taking these medications for signs of problems.
- Some types of heart block have been linked to genetic mutations (changes in the genes).
- An overly active vagus nerve also can cause heart block. You have one vagus nerve on each side of your body. These nerves run from your brain stem all the way to your bdomen. Activity in the vagus nerve slows the heart rate.
In some cases, acquired heart blockmay go away if the factor causing it is treated or resolved. For example, heart block that occurs after a heart attack or surgery may go away during recovery.
Also, if a medication is causing heart block, the disorder may go away if the medication is stopped or the dosage is lowered. Always talk with your doctor before you change the way you take your medications.
Who is at highest risk?
The risk factors for congenital and acquired heart block are different.
Congenital Heart Block
- If a pregnant patient has an autoimmune disease, such as lupus, her fetus is at risk for heart block.
- Autoimmune diseases can cause the body to make proteins called antibodies that can cross the placenta. (The placenta is the organ that attaches the umbilical cord to the mother's womb.) These antibodies may damage the baby's heart and lead to congenital heart block.
- Congenital heart defects also may result in congenital heart block. These defects are problems with the heart's structure that are present at birth. Most of the time, doctors don't know what causes these defects.
- Heredity may play a role in certain heart defects. For example, a parent who has a congenital heart defect may be more likely than other people to have a child with the condition.
Acquired Heart Block
- Acquired heart block can occur in people of any age. However, most types of the disorder are more common in older people. This is because many of the risk factors are more common in older people.
- People who have a history of heart disease or heart attacks are more likely to have heart block. Examples of heart disease that can lead to heart block include heart failure, coronary heart disease, and cardiomyopathy (heart muscle diseases).
- Other diseases also may raise the risk of heart block. These include sarcoidosis and the degenerative muscle disorders Lev's disease and Lenegre's disease.
- Exposure to toxic substances or taking certain medicines, such as digitalis, also can raise your risk of heart block.
- Well-trained athletes and young people are at higher risk for first-degree heart block caused by an overly active vagus nerve. You have one vagus nerve on each side of your body. These nerves run from your brain stem all the way to your abdomen. Activity in the vagus nerve slows the heart rate.
Diagnosis
Heart block may be diagnosed as part of a routine doctor's visit or during an emergency situation. (Third-degree heart block) is often an emergency.) Your doctor will diagnose heart block based on your family and medical histories, a physical exam, and results from tests such as:
- Electrocardiogram (EKG): Doctors usually use a test called an EKG (electrocardiogram) to help diagnose heart block. An EKG shows how fast the heart is beating and its rhythm (steady or irregular). The test also records the strength and timing of electrical signals as they pass through each part of the heart
- Holter monitors: A Holter monitor records the heart's electrical signals for a full 24- or 48-hour period. You wear one while you do your normal daily activities. This allows the monitor to record your heart for longer than a standard EKG.
- Event monitors: An event monitor is similar to a Holter monitor. You wear an event monitor while doing your normal activities. However, an event monitor only records your heart's electrical activity at certain times while you're wearing it.
- Electrophysiology study: For some cases of heart block, doctors may do electrophysiology studies (EPS). During this test, a thin, flexible wire is passed through a vein in your groin (upper thigh) or arm to your heart. The wire records your heart's electrical signals.
When to seek urgent medical care?
If you are experiencing the above-mentioned symptoms for the first time or are severe, call 9–1–1 or have someone drive you to the hospital emergency room. If you have milder symptoms, talk with your doctor right away to find out whether you need prompt treatment.
Treatment options
Treatment depends on the type of heart block you have. First-degree heart block usually needs no treatment.
If you have second-degree heart block, you may need a pacemaker. A pacemaker is a small device that's placed under the skin of your chest or abdomen. This device uses electrical pulses to prompt the heart to beat at a normal rate.
If you have third-degree heart block, you will need a pacemaker. In an emergency, a temporary pacemaker may be used until you can get a long-term device. Most people who have third-degree heart block need pacemakers for the rest of their lives.
Some people who have third-degree congenital heart block do not need a pacemaker for many years. Others may need a pacemaker at a young age or during infancy.
If a pregnant patient has an autoimmune disease, such as lupus, her fetus is at risk for heart block. If a heart block is detected in a fetus, the mother may be given a medication to reduce the fetus' risk of developing serious heart block.
Sometimes acquired heart block goes away if the factor causing it is treated or resolved. For example, heart block that occurs after a heart attack or surgery may go away during recovery.
Also, if a medication is causing heart block, the condition may go away if the medication is stopped or the dosage is lowered. Always talk with your doctor before you change the way you take your medicines.
Medications to avoid
Patients diagnosed with second-degree atrioventricular block and third-degree atrioventricular block should avoid using the following medications:
- Amiodarone
- Propafenone
- Timolol
If you have been diagnosed with second-degree atrioventricular block and third-degree atrioventricular block, consult your physician before starting or stopping any of these medications.
Where to find medical care for Heart block?
Directions to Hospitals Treating Heart Block
What to expect (Outlook/Prognosis)?
- First-degree heart block may not cause any symptoms or require treatment.
- If you have second-degree heart block that doesn't require a pacemaker, talk with your doctor about keeping your heart healthy. Your doctor will tell you whether you need ongoing care for your condition.
- People who have third-degree heart block and some people who have second-degree heart block need pacemakers. This device uses electrical pulses to prompt the heart to beat at a normal rate.
- If you have a pacemaker, you should take special care to avoid things that may interfere with it. Avoid close or prolonged contact with electrical devices and devices that have strong magnetic fields. These objects can keep your pacemaker from working properly.
- Let all of your doctors, dentists, and medical technicians know that you have a pacemaker. You also should notify airport screeners.
- Your doctor can give you a card that states what kind of pacemaker you have. Carry this card in your wallet. You may want to consider wearing a medical ID bracelet or necklace that states that you have a pacemaker.
- Certain medical procedures can disrupt pacemakers. Examples include magnetic resonance imaging (MRI), electrocauterization during surgery, and shockwave lithotripsy to get rid of kidney stones.
- Your doctor may need to check your pacemaker several times a year to make sure it is working well. Some pacemakers must be checked in the doctor's office, but others can be checked over the phone.
- Ask your doctor about what types of physical activity are safe for you. A pacemaker usually would not limit you from doing sports and physical activity. But you may need to avoid full-contact sports, such as football, that can damage the pacemaker.
Possible complications
Sources
http://www.nhlbi.nih.gov/health/dci/Diseases/hb/hb_whatis.html