Second degree AV block physical examination: Difference between revisions
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=== Appearance of the patient === | === Appearance of the patient === | ||
* Patients with second degree AV block type I (Mobitz I) are usually asymptomatic.<ref name="pmid30586772">{{cite journal| author=Kusumoto FM, Schoenfeld MH, Barrett C, Edgerton JR, Ellenbogen KA, Gold MR | display-authors=etal| 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 | year= 2019 | volume= 140 | issue= 8 | pages= e382-e482 | pmid=30586772 | doi=10.1161/CIR.0000000000000628 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30586772 }}</ref> | * Patients with second degree AV block type I (Mobitz I) are usually asymptomatic.<ref name="pmid30586772">{{cite journal| author=Kusumoto FM, Schoenfeld MH, Barrett C, Edgerton JR, Ellenbogen KA, Gold MR | display-authors=etal| 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 | year= 2019 | volume= 140 | issue= 8 | pages= e382-e482 | pmid=30586772 | doi=10.1161/CIR.0000000000000628 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30586772 }}</ref><ref name="pmid17303157">{{cite journal |vauthors=Bhargava K, Shrivastava S, Singh B, Wellens HJ |title=AV block. Which type and where? |journal=J Electrocardiol |volume=40 |issue=4 |pages=358–9 |date=October 2007 |pmid=17303157 |doi=10.1016/j.jelectrocard.2006.11.007 |url=}}</ref> | ||
* Only patients with previous cardiac condition as myocardial ischemia may appear in distress. | * Only patients with previous cardiac condition as myocardial ischemia may appear in distress. | ||
* Patients with Mobitz II can appear asymptomatic as well. However, in more cases they may be in distress or progress to the more severe third degree AV block. | * Patients with Mobitz II can appear asymptomatic as well. However, in more cases they may be in distress or progress to the more severe third degree AV block. | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Elsaiey, MBBCH [2]
Overview
Patients with second degree AV block are usually asymptomatic. However, patients with previous chronic cardiac condition may appear in a distress. In symptomatic patients, common physical examination findings include bradycardia, hypotension, and syncope. Common physical examination in patients associated with heart failure include lung crackles, jugular venous distension, and peripheral edema.
Physical examination
Appearance of the patient
- Patients with second degree AV block type I (Mobitz I) are usually asymptomatic.[1][2]
- Only patients with previous cardiac condition as myocardial ischemia may appear in distress.
- Patients with Mobitz II can appear asymptomatic as well. However, in more cases they may be in distress or progress to the more severe third degree AV block.
- Patients may appear pale in cases of bradycardia with decreased cardiac output.[3]
Vitals
- Bradycardia with an irregular pulse
- Lightheadedness
- Hypotension
- Syncope or presyncope
Neck
- Jugular venous distension
Lungs
- Bibasilar crackles in patients with exacerbated heart failure
Extremities
- Peripheral edema
References
- ↑ Kusumoto FM, Schoenfeld MH, Barrett C, Edgerton JR, Ellenbogen KA, Gold MR; et al. (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): e382–e482. doi:10.1161/CIR.0000000000000628. PMID 30586772.
- ↑ Bhargava K, Shrivastava S, Singh B, Wellens HJ (October 2007). "AV block. Which type and where?". J Electrocardiol. 40 (4): 358–9. doi:10.1016/j.jelectrocard.2006.11.007. PMID 17303157.
- ↑ Rosen KM, Dhingra RC, Loeb HS, Rahimtoola SH (1973). "Chronic heart block in adults. Clinical and electrophysiological observations". Arch Intern Med. 131 (5): 663–72. PMID 4701376.