Third degree AV block causes: Difference between revisions
Aditya Ganti (talk | contribs) (→Causes) |
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* Patients are relatively asymptomatic at rest. | * Patients are relatively asymptomatic at rest. | ||
* Since the fixed heart rate is not able to adjust for exertion the become symptomatic with activity. | * Since the fixed heart rate is not able to adjust for exertion the become symptomatic with activity. | ||
* It may happen in the context of major structural abnormalities | * It may happen in the context of major structural abnormalities | ||
**Patients with L-transposition of the great arteries and two normally sized ventricles, as well as those with L-looped single-ventricle | |||
**L-transposition of the great arteries, are at risk for spontaneous complete heart block and should undergo routine screening for complete heart block. | |||
* Or might be associated with maternal antibodies to SS-A (Ro) and SS-B (La). | * Or might be associated with maternal antibodies to SS-A (Ro) and SS-B (La). | ||
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* '''Ischemia or infarction:''' | * '''Ischemia or infarction:''' | ||
:* AV node (AVN) block associated with inferior wall myocardial infarction (MI) | :* AV node (AVN) block associated with [[Myocardial infarction|inferior wall myocardial infarction]] (MI) | ||
:*His-Purkinje block associated with anterior wall MI | :*[[His-Purkinje fibers|His-Purkinje]] block associated with [[MI|anterior wall MI]] | ||
*'''Drugs''': | *'''Drugs''': |
Revision as of 02:01, 11 April 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Soroush Seifirad, M.D.[2] Cafer Zorkun, M.D., Ph.D. [3]; Raviteja Guddeti, M.B.B.S. [4]; Hilda Mahmoudi M.D., M.P.H.[5]
Overview
Many conditions can cause third-degree AV block, but the most common cause is coronary ischemia. The progressive degeneration of the electrical conduction system of the heart can lead to a complete heart block. In addition, acute myocardial infarction may present with third-degree AV block.
Third degree heart block may also be congenital and has been linked to the presence of lupus in the mother. The cause of congenital third-degree heart block in many patients is unknown.
Causes
Infiltration, fibrosis, or loss of connection in the heart conduction system can tend to heart block. A complete heart block can be either congenital or acquired.
Congenital form of complete heart block
- Usually occurs at AVN.
- Patients are relatively asymptomatic at rest.
- Since the fixed heart rate is not able to adjust for exertion the become symptomatic with activity.
- It may happen in the context of major structural abnormalities
- Patients with L-transposition of the great arteries and two normally sized ventricles, as well as those with L-looped single-ventricle
- L-transposition of the great arteries, are at risk for spontaneous complete heart block and should undergo routine screening for complete heart block.
- Or might be associated with maternal antibodies to SS-A (Ro) and SS-B (La).
Common causes of acquired AV block are as follows:
- Ischemia or infarction:
- AV node (AVN) block associated with inferior wall myocardial infarction (MI)
- His-Purkinje block associated with anterior wall MI
- Drugs:
- Class Ia antiarrhythmics: quinidine, procainamide, disopyramide
- Class Ic antiarrhythmics: eg, flecainide, encainide, propafenone
- Class II antiarrhythmics: beta-blockers
- Class III antiarrhythmics: eg, amiodarone, sotalol, dofetilide, ibutilide
- Class IV antiarrhythmics: calcium channel blockers
- Digoxin and other cardiac glycosides
- Infectious disease:
- Lyme borreliosis (particularly in endemic areas),
- Myocarditis
- Aspergillus myocarditis
- Chagas disease: Trypanosoma cruzi infection
- Varicella-zoster virus infection
- Valve ring abscess
- Degenerative diseases:
- Lenègre disease (sclerodegenerative process involving only the conduction system)
- Lev disease (calcification of the conduction system and valves)
- Noncompaction cardiomyopathy
- Nail-patella syndrome
- Mitochondrial myopathy
- Rheumatic diseases:
- Infiltrative pathologies:
- Neuromuscular disorders:
- Metabolic abnormality:
- Toxins:
- Grayanotoxin:“Mad” honey
- Natural cardiac glycosides such as oleandrin
- Bradycardia-related block
- Iatrogenic heart block
- Aortic valve surgery
- Septal alcohol ablation
- Percutaneous coronary intervention (PCI) to the left anterior descending artery
- Ablation of the slow or fast pathway of the AVN
- Ablation of accessory pathways near AVN
Life Threatening Causes
Third degree heart block is a life-threatening condition and must be treated as such irrespective of the causes. Life-threatening conditions can result in death or permanent disability within 24 hours if left untreated.
Common Causes
- Acute rheumatic fever
- Coronary ischemia
- Myocardial infarction [1]
- Systemic lupus erythematosus
- Valvular heart disease
Causes by Organ System
Third degree AV block causes developed by WikiDoc.org
Causes in Alphabetical Order
References
- ↑ 1.0 1.1 1.2 Malla RR, Sayami A (2007). "In hospital complications and mortality of patients of inferior wall myocardial infarction with right ventricular infarction". JNMA J Nepal Med Assoc. 46 (167): 99–102. PMID 18274563.
- ↑ 2.0 2.1 2.2 2.3 "Congenital complete atrioventricular". Retrieved 21 August 2013. Text "block. " ignored (help)
- ↑ 3.0 3.1 Lionakis N, Moyssakis I, Gialafos E, Dalianis N, Votteas V (2008). "Aortic dissection and third-degree atrioventricular block in a patient with a hypertensive crisis". J Clin Hypertens (Greenwich). 10 (1): 69–72. PMID 18174773. Unknown parameter
|month=
ignored (help) - ↑ 4.0 4.1 Liu R, Qiao SB, Hu FH, Yang WX, Yuan JS (2012). "[Clinical features of five patients with delayed third degree atrioventricular block after ethanol septal ablation for hypertrophic obstructive cardiomyopathy]". Zhonghua Xin Xue Guan Bing Za Zhi (in Chinese). 40 (12): 1009–11. PMID 23363714. Unknown parameter
|month=
ignored (help) - ↑ 5.0 5.1 Sykes JA, Lubega J, Ezetendu C, Verma R, O'Connor B, Kalyanaraman M (2011). "Asymptomatic complete atrioventricular block in a 13-year-old girl". Pediatr Emerg Care. 27 (11): 1081–3. doi:10.1097/PEC.0b013e3182360674. PMID 22068075. Unknown parameter
|month=
ignored (help) - ↑ 6.0 6.1 Wills BK, Liu JM, Wahl M (2010). "Third-degree AV block [from extended-release diltiazem ingestion in a nine-month-old". J Emerg Med. 38 (3): 328–31. doi:10.1016/j.jemermed.2007.10.053. PMID 18403171. Unknown parameter
|month=
ignored (help) - ↑ 7.0 7.1 Amasyalı B, Barçın C, Kılıç A (2011). "[Supra-His complete atrioventricular block in a patient with subclinical hyperthyroidism]". Turk Kardiyol Dern Ars (in Turkish). 39 (8): 693–6. PMID 22257810. Unknown parameter
|month=
ignored (help) - ↑ 8.0 8.1 Maleki AR, Nikyar B, Hosseini SM (2012). "Third-Degree Heart Block in Thalassemia major: A Case Report". Iran J Pediatr. 22 (2): 260–4. PMC 3446065. PMID 23056897. Unknown parameter
|month=
ignored (help) - ↑ 9.0 9.1 Bhattacharya IS, Dweck M, Francis M (2010). "Lyme carditis: a". J R Coll Physicians Edinb. 40 (2): 121–2. doi:10.4997/JRCPE.2010.207. PMID 21125053. Text "reversible cause of complete atrioventricular block " ignored (help); Unknown parameter
|month=
ignored (help) - ↑ 10.0 10.1 Wagner V, Zima E, Gellér L, Merkely B (2010). "[Acute atrioventricular block in chronic Lyme disease]". Orv Hetil (in Hungarian). 151 (39): 1585–90. doi:10.1556/OH.2010.28965. PMID 20840915. Unknown parameter
|month=
ignored (help) - ↑ 11.0 11.1 Semmler D, Blank R, Rupprecht H (2010). "Complete AV block in Lyme carditis: an important differential diagnosis". Clin Res Cardiol. 99 (8): 519–26. doi:10.1007/s00392-010-0152-8. PMID 20464556. Unknown parameter
|month=
ignored (help) - ↑ 12.0 12.1 Frikha Z, Abid L, Abid D; et al. (2011). "Cardiac tamponade and paroxysmal third-degree atrioventricular block revealing a primary cardiac non-Hodgkin large B-cell lymphoma of the right ventricle: a case report". J Med Case Rep. 5: 433. doi:10.1186/1752-1947-5-433. PMC 3180417. PMID 21892927.
- ↑ 13.0 13.1 Houchaymi Z, Helou S, Ballout J (2010). "[Pericardial tamponade and third-degree atrioventricular block revealing a primary cardiac lymphoma]". Rev Med Interne (in French). 31 (11): e4–6. doi:10.1016/j.revmed.2010.01.014. PMID 20605278. Unknown parameter
|month=
ignored (help) - ↑ 14.0 14.1 van Cleef AN, Schuurman MJ, Busari JO (2011). "Third-degree atrioventricular block in an adolescent following acute alcohol intoxication". BMJ Case Rep. 2011. doi:10.1136/bcr.07.2011.4547. PMID 22679160.
- ↑ 15.0 15.1 Brvar M, Bunc M (2009). "High-degree atrioventricular block in acute ethanol poisoning: a case report". Cases J. 2: 8559. doi:10.4076/1757-1626-2-8559. PMC 2769457. PMID 19918387.
- ↑ 16.0 16.1 Tian Z, Fang Q, Zhao DC; et al. (2010). "[The clinico-pathological manifestation of cardiac involvement in eosinophilic diseases]". Zhonghua Nei Ke Za Zhi (in Chinese). 49 (8): 684–7. PMID 20979789. Unknown parameter
|month=
ignored (help) - ↑ 17.0 17.1 Facenda-Lorenzo M, Hernández-Afonso J, Rodríguez-Esteban M, de León-Hernández JC, Grillo-Pérez JJ (2012). "Cardiac Manifestations in Myotonic Dystrophy Type 1 Patients Followed Using a Standard Protocol in a Specialized Unit". Rev Esp Cardiol. doi:10.1016/j.recesp.2012.08.011. PMID 23194837. Unknown parameter
|month=
ignored (help) - ↑ 18.0 18.1 Femenía F, Arce M, Arrieta M (2010). "[Systemic sclerosis complicated with syncope and complete AV block]". Medicina (B Aires) (in Spanish; Castilian). 70 (5): 442–4. PMID 20920962.
- ↑ 19.0 19.1 Thakar S, Chandra P, Pednekar M, Kabalkin C, Shani J (2012). "Complete heart block following a blow on the chest by a soccer ball: a rare manifestation of commotio cordis". Ann Noninvasive Electrocardiol. 17 (3): 280–2. doi:10.1111/j.1542-474X.2012.00518.x. PMID 22816548. Unknown parameter
|month=
ignored (help) - ↑ 20.0 20.1 Portet N, Riu B, Bounes V, Minville V, Fourcade O (2012). "Left ventricular-right atrial communication with third-degree atrioventricular block after thoracic trauma". J Emerg Med. 43 (6): e385–8. doi:10.1016/j.jemermed.2010.11.059. PMID 21621364. Unknown parameter
|month=
ignored (help)