Second degree AV block physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Elsaiey, MBBCH [2] Syed Musadiq Ali M.B.B.S.[3]

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 the previous cardiac condition such as myocardial ischemia may appear in distress.
Patients with Mobitz II can appear asymptomatic as well. However, they may be in distress or progress to the more severe third-degree AV block in some cases.
Patients may appear pale in cases of bradycardia with decreased cardiac output.^[3]

Vitals

Bradycardia with an irregular pulse^[4]
Lightheadedness
Hypotension^[5]
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.
↑ Schneider MD, Roller DH, Morganroth J, Josephson ME (July 1978). "The syndromes of familial atrioventricular block with sinus bradycardia: prognostic indices, electrophysiologic and histopathologic correlates". Eur J Cardiol. 7 (5–6): 337–51. PMID 699934.
↑ Trappe HJ (September 2016). "[Consciousness disorders from cardiological view]". Dtsch. Med. Wochenschr. (in German). 141 (19): 1361–9. doi:10.1055/s-0042-103177. PMID 27642736.

Template:WikiDoc Sources

[pmid30586772-1] 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.

[pmid17303157-2] 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.

[pmid4701376-3] 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.

[pmid699934-4] Schneider MD, Roller DH, Morganroth J, Josephson ME (July 1978). "The syndromes of familial atrioventricular block with sinus bradycardia: prognostic indices, electrophysiologic and histopathologic correlates". Eur J Cardiol. 7 (5–6): 337–51. PMID 699934.

[pmid27642736-5] Trappe HJ (September 2016). "[Consciousness disorders from cardiological view]". Dtsch. Med. Wochenschr. (in German). 141 (19): 1361–9. doi:10.1055/s-0042-103177. PMID 27642736.

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