Third degree AV block history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]
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Overview
Patients with third degree AV block typically experience a lower overall measured heart rate (as low as 28 beats per minute during sleep), low blood pressure, and poor circulation. In some cases, exercising may be difficult, as the heart cannot react quickly enough to sudden changes in demand or sustain the higher heart rates required for sustained activity. Complete heart block associated with a slower pacemaker can result in dizziness, presyncope and syncope.
History
The following history should be elicited while investigating a case of complete heart block
- History of any cardiac disease
- History of use of any medications which affect the conduction through the conducting system (beta blockers, calcium channel blockers, digitalis)
- History of previous cardiac interventions (aortic valve surgery [TAVI], ASD, VSD and TGA repairs, ablation procedures etc.,)
Symptoms
Patients with complete heart block present with varied symptomatology.
- Some patients may be asymptomatic or have symptoms related to hypotension.
- Complete heart block with narrow QRS comples (level of block above His bundle) is associated with minimal symptoms.
- Patients with complete heart block and wide QRS complex (level of block below the His bundle) may present with