Third degree AV block echocardiography and ultrasound: Difference between revisions

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{{Third degree AV block}}
{{Third degree AV block}}
{{CMG}}; {{AE}} {{Soroush}}
{{CMG}}; {{AE}} {{Sara.Zand}} {{Soroush}}
==Overview==
==Overview==
[[Echocardiography]] is useful for evaluation of underlying [[structural heart disease]] in [[patients]] presented with [[bradycardia]] or [[conduction abnormality]]. Common indications for [[echocardiography]] in suspicion of [[cardiac origin]] of [[bradycardia]] or [[conduction disorder]] may include [[syncope]], [[lightheadedness]]/[[presyncope]],  [[symptoms]] related to [[aortic stenosis]], [[hypertrophic  cardiomyopathy]], [[heart  failure]].


There are no echocardiography/ultrasound findings associated with third degree AV block.
==[[Echocardiography]]==
[[Echocardiography]] is useful for evaluation of underlying [[structural heart disease]] in [[patients]] presented with [[bradycardia]] or [[conduction abnormality]] including [[cardiomyopathy]], [[valvular heart disease]], [[congenital]] anomalies, [[tumors]], [[infections]], [[infiltrative processes]], [[immunologically]] mediated [[conditions]], and diseases of the [[great vessels]] and [[pericardium]].
* Common indications for [[echocardiography]] in suspicion of [[cardiac origin]] of [[bradycardia]] or [[conduction disorder]] may include:
:* [[Syncope]]
:* [[Lightheadedness]]/[[presyncope]]
:* [[Symptoms]] related to [[aortic stenosis]], [[hypertrophic  cardiomyopathy]], [[heart  failure]]


OR


Echocardiography/ultrasound may be helpful in the diagnosis of third degree AV block. Findings on an echocardiography/ultrasound suggestive of/diagnostic of third degree AV block include [finding 1], [finding 2], and [finding 3].
{| style="cellpadding=0; cellspacing= 0; width: 600px;"
|-
| style="padding: 0 5px; font-size: 100%; background: #4682B4; color: #FFFFFF;" align=center |'''Recommendations for Echocardiography in Bradycardia or Conduction disorder'''
|-
|style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |'''[[Echocardiography]]  ([[ACC AHA guidelines classification scheme|Class I, Level of Evidence B]]):'''
|-
|style="padding: 0 5px; font-size: 100%; background: #F5F5F5; width: 70%" align=left|
❑ [[Echocardiography]] is recommended in [[patients]] with newly identified [[LBBB]], [[second-degree Mobitz type II atrioventricular block]], [[high-grade atrioventricular block]], or [[third-degree atrioventricular block]] with or without apparent [[structural heart disease]] or [[coronary artery disease]]<br>
|-
|style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left|''' [[Echocardiography]] ([[ACC AHA guidelines classification scheme| Class IIa, Level of Evidence B]]) :'''
|-
|style="padding: 0 5px; font-size: 100%; background: #F5F5F5; width: 70%" align=left|
❑ [[Echocardiography]] is recommended in suspicion of [[structural heart disease]] in [[patients]] presented with [[bradycardia]] or [[conduction disorders]] other than [[LBBB]], [[second-degreeMobitz type II atrioventricular block]], [[high-grade atrioventricular block]], or [[third-degree atrioventricular block]]
|-
|style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |'''Advanced [[imaging]] : ([[ACC AHA guidelines classification scheme|Class IIa, Level of Evidence C]])'''
|-
|style="padding: 0 5px; font-size: 100%; background: #F5F5F5; width: 70%" align=left|
❑ In suspicion of [[structural heart disease]] in [[patients]] presented with [[bradycardia]] or [[bundle branch block]], [[transesophageal echocardiography]], [[computed tomography]], [[cardiac magnetic resonance imaging]] ([[MRI]]),or [[nuclear imaging]] is recommended<br>
|-
|-
|style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |'''Cardiac imaging : ([[ACC AHA guidelines classification scheme|Class III, Level of Evidence B]])'''
|-
|style="padding: 0 5px; font-size: 100%; background: #F5F5F5; width: 70%" align=left|
❑ Routine [[cardiac]] imaging is not recommended in [[patients]] with  asymptomatic [[sinus bradycardia]] or [[first-degree atrioventricular block]] and no clinical evidence of [[structural heart disease]]<br>


OR
|}
 
<span style="font-size:85%">'''Abbreviations:'''
There are no echocardiography/ultrasound  findings associated with third degree AV block. However, an echocardiography/ultrasound  may be helpful in the diagnosis of complications of third degree AV block, which include [complication 1], [complication 2], and [complication 3].
'''PPM:''' [[Permanent pacemaker]];
 
'''LBBB:''' [[Left bundle branch block]]
[[Transthoracic echocardiography]] is used to diagnose [[cardiomyopathy|cardiomyopathies]] and [[valvular heart disease]]s as causes of third degree heart block. [[Transesophageal echocardiogram]] aids in the diagnosis of valvular abnormalities like valve abscesses. Left ventricular function can be determined using an echo, before placement of a [[pacemaker]] or [[defibrillator]].
</span>
 
<br>
==Echocardiography/Ultrasound==
{|
 
! colspan="2" style="background: PapayaWhip;" align="center" + |The above table adopted from 2018 AHA/ACC/HRS Guideline<ref name="KusumotoSchoenfeld2019">{{cite journal|last1=Kusumoto|first1=Fred M.|last2=Schoenfeld|first2=Mark H.|last3=Barrett|first3=Coletta|last4=Edgerton|first4=James R.|last5=Ellenbogen|first5=Kenneth A.|last6=Gold|first6=Michael R.|last7=Goldschlager|first7=Nora F.|last8=Hamilton|first8=Robert M.|last9=Joglar|first9=José A.|last10=Kim|first10=Robert J.|last11=Lee|first11=Richard|last12=Marine|first12=Joseph E.|last13=McLeod|first13=Christopher J.|last14=Oken|first14=Keith R.|last15=Patton|first15=Kristen K.|last16=Pellegrini|first16=Cara N.|last17=Selzman|first17=Kimberly A.|last18=Thompson|first18=Annemarie|last19=Varosy|first19=Paul D.|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|volume=140|issue=8|year=2019|issn=0009-7322|doi=10.1161/CIR.0000000000000628}}</ref>
There are no echocardiography/ultrasound findings associated with third degree AV block.
|-
 
|}
OR
 
Echocardiography/ultrasound may be helpful in the diagnosis of third degree AV block. Findings on an echocardiography/ultrasound suggestive of/diagnostic of third degree AV block include:
*[Finding 1]
*[Finding 2]
*[Finding 3]
 
OR
 
There are no echocardiography/ultrasound findings associated with third degree AV block. However, an echocardiography/ultrasound  may be helpful in the diagnosis of complications of third degree AV block, which include:
*[Complication 1]
*[Complication 2]
*[Complication 3]


==References==
==References==

Latest revision as of 07:49, 11 July 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Zand, M.D.[2] Soroush Seifirad, M.D.[3]

Overview

Echocardiography is useful for evaluation of underlying structural heart disease in patients presented with bradycardia or conduction abnormality. Common indications for echocardiography in suspicion of cardiac origin of bradycardia or conduction disorder may include syncope, lightheadedness/presyncope, symptoms related to aortic stenosis, hypertrophic cardiomyopathy, heart failure.

Echocardiography

Echocardiography is useful for evaluation of underlying structural heart disease in patients presented with bradycardia or conduction abnormality including cardiomyopathy, valvular heart disease, congenital anomalies, tumors, infections, infiltrative processes, immunologically mediated conditions, and diseases of the great vessels and pericardium.


Recommendations for Echocardiography in Bradycardia or Conduction disorder
Echocardiography (Class I, Level of Evidence B):

❑ Echocardiography is recommended in patients with newly identified LBBB, second-degree Mobitz type II atrioventricular block, high-grade atrioventricular block, or third-degree atrioventricular block with or without apparent structural heart disease or coronary artery disease

Echocardiography ( Class IIa, Level of Evidence B) :

❑ Echocardiography is recommended in suspicion of structural heart disease in patients presented with bradycardia or conduction disorders other than LBBB, second-degreeMobitz type II atrioventricular block, high-grade atrioventricular block, or third-degree atrioventricular block

Advanced imaging : (Class IIa, Level of Evidence C)

❑ In suspicion of structural heart disease in patients presented with bradycardia or bundle branch block, transesophageal echocardiography, computed tomography, cardiac magnetic resonance imaging (MRI),or nuclear imaging is recommended

Cardiac imaging : (Class III, Level of Evidence B)

❑ Routine cardiac imaging is not recommended in patients with asymptomatic sinus bradycardia or first-degree atrioventricular block and no clinical evidence of structural heart disease

Abbreviations: PPM: Permanent pacemaker; LBBB: Left bundle branch block

The above table adopted from 2018 AHA/ACC/HRS Guideline[1]

References

  1. ↑ Kusumoto, Fred M.; Schoenfeld, Mark H.; Barrett, Coletta; Edgerton, James R.; Ellenbogen, Kenneth A.; Gold, Michael R.; Goldschlager, Nora F.; Hamilton, Robert M.; Joglar, José A.; Kim, Robert J.; Lee, Richard; Marine, Joseph E.; McLeod, Christopher J.; Oken, Keith R.; Patton, Kristen K.; Pellegrini, Cara N.; Selzman, Kimberly A.; Thompson, Annemarie; Varosy, Paul D. (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). doi:10.1161/CIR.0000000000000628. ISSN 0009-7322.

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