Second 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: Cafer Zorkun, M.D., Ph.D. [2]
Overview
Patients with second degree AV block are asymptomatic. Some patients may present with symptoms of reduced cardiac output. Symptoms include dizziness, fatigue, presyncope or syncope, and light headedness.
History
- History from patients with second degree AV block should involve asking about the following:[1][2]
- Congenital cardiac disease
- Current heart condition
- Recent or previous cardiac procedures
- History of medications
Symptoms
- Common symptoms in patients with second degree atrioventricular block include:[3][4]
- Mobitz type 1 second degree AV block (Wenckebach) is often asymptomatic and can be seen in active, healthy patients without known heart disease.[5][6]
- Mobitz type 1 second degree AV block (Wenckebach) may occur during exercise causing exertional intolerance or dizziness, or syncope.
- In patients with intermittent atrioventricular block leading syncope, initial evaluation including resting ECG, physical exam, echocardiography may be normal.
- Intermittent episodes of the atrioventricular block may be paroxysmal and found with long-term monitoring.[7]
- It was identified that in patients with syncope and evidence of bundle branch block or bifascicular block in resting ECG, there was 61% His Purkinje conduction abnormalities in electrophysiologic study.
- Symptoms in patients with an atrioventricular block that conducts in a 2:1 pattern include fatigue and dizziness particularly if it persists during exertion.
- If the sinus rate is slow and only a few beats are conducted, there may be a significantly reduced cardiac output.
References
- ↑ Zeppilli P, Fenici R, Sassara M, Pirrami MM, Caselli G (September 1980). "Wenckebach second-degree A-V block in top-ranking athletes: an old problem revisited". Am. Heart J. 100 (3): 281–94. doi:10.1016/0002-8703(80)90140-4. PMID 7405798.
- ↑ "StatPearls". 2020. PMID 29083636.
- ↑ Bexton RS, Camm AJ (March 1984). "Second degree atrioventricular block". Eur. Heart J. 5 Suppl A: 111–4. doi:10.1093/eurheartj/5.suppl_a.111. PMID 6373268.
- ↑ Wogan JM, Lowenstein SR, Gordon GS (1993). "Second-degree atrioventricular block: Mobitz type II". J Emerg Med. 11 (1): 47–54. doi:10.1016/0736-4679(93)90009-v. PMID 8445186.
- ↑ Meimoun P, Zeghdi R, D'Attelis N, Berrebi A, Braunberger E, Deloche A; et al. (2002). "Frequency, predictors, and consequences of atrioventricular block after mitral valve repair". Am J Cardiol. 89 (9): 1062–6. doi:10.1016/s0002-9149(02)02276-2. PMID 11988196.
- ↑ Mangi MA, Jones WM, Napier L. PMID 29493981. Missing or empty
|title=(help) - ↑ Brignole M, Deharo JC, De Roy L, Menozzi C, Blommaert D, Dabiri L, Ruf J, Guieu R (July 2011). "Syncope due to idiopathic paroxysmal atrioventricular block: long-term follow-up of a distinct form of atrioventricular block". J Am Coll Cardiol. 58 (2): 167–73. doi:10.1016/j.jacc.2010.12.045. PMID 21570228.