First degree AV block history and symptoms: Difference between revisions
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{{First degree AV block}} | {{First degree AV block}} | ||
{{CMG}}; {{AE}} {{Sara.Zand}} {{AEL}} | |||
==Overview== | |||
[[Symptoms]] related to [[atrioventricular block]] vary and related to the degree of [[atrioventricular block]], the [[ventricular rate]], and the frequency of its occurrence. | |||
[[Patients]] presented with [[First-degree AV block]] are usually asymptomatic. However, severe [[first-degree AV block]] may cause [[symptoms]] similar to [[pace maker syndrome]] including [[heart failure]] [[symptoms]], [[exertional intolerance]]. [[Pseudo pacemaker syndrome]] is defined when the [[PR interval]] is >300ms leading to [[atrial]] contraction during the closed [[atrioventricular valves]], loss of [[atrioventricular]] synchrony and decrease in [[cardiac output]] and an increase [[pulmonary capillary wedge pressure]]. | |||
== | == History and symptoms == | ||
=== History === | |||
*In [[patients]] presented with [[symptoms]] suspicious for [[bradycardia]] or [[conduction disorder]], comprehensive [[history]] should be taken about:<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> | |||
::*Timing, [[duration]], [[severity]], [[longevity]], [[circumstances]], [[triggers]] and [[alleviating]] factors of [[symptoms]] | |||
::* The relationship of the [[symptoms]] to [[medications]], [[meals]], [[medical interventions]], [[emotional]] distress, [[physical exertion]], [[positional changes]], and triggers (eg, [[urination]], [[defecation]], [[cough]], [[prolonged]] [[standing]], [[shaving]]) | |||
::* systemic [[illness]] or [[heart]] disease | |||
::* [[cardiovascular]] risk assessment, [[family history]], [[travel history]], and review of [[systems]] | |||
=== Symptoms === | |||
::*[[Symptoms]] related to [[atrioventricular block]] vary and related to the degree of [[atrioventricular block]], the [[ventricular rate]], and the frequency of its occurrence. | |||
* [[Patients]] presented with [[First-degree AV block]] are usually asymptomatic. However, severe [[First-degree AV block]] may cause [[symptoms]] similar to [[pace maker syndrome]] including [[heart failure]] [[symptoms]], [[exertional intolerance]]. | |||
* Common [[symptoms]] associate with profound [[First-degree atrioventricular block]] with [[PR interval]] >300 ms include: | |||
* [[Fatigue]] | |||
* [[Exertional intolerance]] | |||
* [[Malaise]] | |||
* [[Lightheadedness]] | |||
* [[Chest pain]] | |||
* [[Syncope]] | |||
*[[Pseudo pacemaker syndrome]] is defined when the [[PR interval]] is >300ms leading to [[atrial]] contraction during the closed [[atrioventricular valves]], loss of [[atrioventricular]] synchrony and decrease in [[cardiac output]] and an increase [[pulmonary capillary wedge pressure]].<ref name="Ando'Versaci2005">{{cite journal|last1=Ando'|first1=Giuseppe|last2=Versaci|first2=Francesco|title=Ventriculo-atrial gradient due to first degree atrio-ventricular block: a case report|journal=BMC Cardiovascular Disorders|volume=5|issue=1|year=2005|issn=1471-2261|doi=10.1186/1471-2261-5-23}}</ref> | |||
==Reference== | |||
{{Reflist|2}} | {{Reflist|2}} | ||
Latest revision as of 07:48, 22 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] Ahmed Elsaiey, MBBCH [3]
Overview
Symptoms related to atrioventricular block vary and related to the degree of atrioventricular block, the ventricular rate, and the frequency of its occurrence. Patients presented with First-degree AV block are usually asymptomatic. However, severe first-degree AV block may cause symptoms similar to pace maker syndrome including heart failure symptoms, exertional intolerance. Pseudo pacemaker syndrome is defined when the PR interval is >300ms leading to atrial contraction during the closed atrioventricular valves, loss of atrioventricular synchrony and decrease in cardiac output and an increase pulmonary capillary wedge pressure.
History and symptoms
History
- In patients presented with symptoms suspicious for bradycardia or conduction disorder, comprehensive history should be taken about:[1]
- Timing, duration, severity, longevity, circumstances, triggers and alleviating factors of symptoms
- The relationship of the symptoms to medications, meals, medical interventions, emotional distress, physical exertion, positional changes, and triggers (eg, urination, defecation, cough, prolonged standing, shaving)
- systemic illness or heart disease
- cardiovascular risk assessment, family history, travel history, and review of systems
Symptoms
- Symptoms related to atrioventricular block vary and related to the degree of atrioventricular block, the ventricular rate, and the frequency of its occurrence.
- Patients presented with First-degree AV block are usually asymptomatic. However, severe First-degree AV block may cause symptoms similar to pace maker syndrome including heart failure symptoms, exertional intolerance.
- Common symptoms associate with profound First-degree atrioventricular block with PR interval >300 ms include:
- Fatigue
- Exertional intolerance
- Malaise
- Lightheadedness
- Chest pain
- Syncope
- Pseudo pacemaker syndrome is defined when the PR interval is >300ms leading to atrial contraction during the closed atrioventricular valves, loss of atrioventricular synchrony and decrease in cardiac output and an increase pulmonary capillary wedge pressure.[2]
Reference
- ↑ 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.
- ↑ Ando', Giuseppe; Versaci, Francesco (2005). "Ventriculo-atrial gradient due to first degree atrio-ventricular block: a case report". BMC Cardiovascular Disorders. 5 (1). doi:10.1186/1471-2261-5-23. ISSN 1471-2261.