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    Atrioventricular Block (Heart Block) : Causes of Atrio-Ventricular Block

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    Liza MP
    Atrioventricular block describes impaired conduction from the atria to the ventricles through the AV node. It occurs when the electrical signal controlling the heartbeat is partially or completely blocked, causing the heart to beat slowly or skip beats. There are three degrees of AV block - first degree causes slowing of conduction, second degree causes intermittent interruptions, and third degree is a complete block where the atria and ventricles contract independently. Causes include acute myocardial infarction, medications, infections, and degeneration of the conduction system. Symptoms range from none in first degree to severe bradycardia, hypotension, syncope, and chest pain in higher degrees. Treatment depends on symptoms but may include atropine, pace

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    Atrioventricular Block (Heart Block) : Causes of Atrio-Ventricular Block

    Uploaded by

    Liza MP
    42 views5 pages
    Atrioventricular block describes impaired conduction from the atria to the ventricles through the AV node. It occurs when the electrical signal controlling the heartbeat is partially or completely blocked, causing the heart to beat slowly or skip beats. There are three degrees of AV block - first degree causes slowing of conduction, second degree causes intermittent interruptions, and third degree is a complete block where the atria and ventricles contract independently. Causes include acute myocardial infarction, medications, infections, and degeneration of the conduction system. Symptoms range from none in first degree to severe bradycardia, hypotension, syncope, and chest pain in higher degrees. Treatment depends on symptoms but may include atropine, pace

    Original Title

    AV BLOCK PUROC

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    Atrioventricular block describes impaired conduction from the atria to the ventricles through the AV node. It occurs when the electrical signal controlling the heartbeat is partially or completely blocked, causing the heart to beat slowly or skip beats. There are three degrees of AV block - first degree causes slowing of conduction, second degree causes intermittent interruptions, and third degree is a complete block where the atria and ventricles contract independently. Causes include acute myocardial infarction, medications, infections, and degeneration of the conduction system. Symptoms range from none in first degree to severe bradycardia, hypotension, syncope, and chest pain in higher degrees. Treatment depends on symptoms but may include atropine, pace

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    © All Rights Reserved
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    Download as docx, pdf, or txt
    42 views5 pages

    Atrioventricular Block (Heart Block) : Causes of Atrio-Ventricular Block

    Uploaded by

    Liza MP
    Atrioventricular block describes impaired conduction from the atria to the ventricles through the AV node. It occurs when the electrical signal controlling the heartbeat is partially or completely blocked, causing the heart to beat slowly or skip beats. There are three degrees of AV block - first degree causes slowing of conduction, second degree causes intermittent interruptions, and third degree is a complete block where the atria and ventricles contract independently. Causes include acute myocardial infarction, medications, infections, and degeneration of the conduction system. Symptoms range from none in first degree to severe bradycardia, hypotension, syncope, and chest pain in higher degrees. Treatment depends on symptoms but may include atropine, pace

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    ATRIOVENTRICULAR BLOCK

    (HEART BLOCK)
     This describes the impairment of
    conduction from the atria to the
    ventricles via the AV junction. This
    impairment occurs when the atrial
    impulse is either delayed or does not
    conduct to the ventricles.
     This is when the electrical signal that
    controls your heartbeat is partially or
    completely blocked which makes
    your heart beat slowly or skip beats
    and your heart can't pump blood
    effectively
     The sites of block include the AV
    node, the bundle of His, and the
    bundle branches.
     The anatomic site of block is either
    nodal or infranodal. Nodal blocks
    occur within the AV node and usually
    result in a narrow QRS complex with
    a ventricular escape rate greater than
    40 beats per minute (bpm).
    Infranodal blocks originate within
    the bundle of His or bundle branches
    and often display a wide QRS
    complex with a slower ventricular
    escape rate of less than 40 bpm. A
    point to remember is that atropine
    can improve AV nodal block but will
    worsen an infranodal block.

    Causes of Atrio-ventricular block


    Causes of temporary block Causes of permanent block
     Acute myocardial infarction: specially  Acute myocardial infarcion specially anterior
    inferior MI MI

     Medications like beta blockers, calcium  Degeneration of conduction system due to


    channel blockers or digoxin advanced age or cardiac calcification of
    mitral or aortic valve
     Inflammation such as myocarditis,
    rheumatic fever or Lupus  Latrogenic damage due to arrythmia
    ablation at the site of AV junction surgery
     Infections: toxoplasmosis (tricuspid valve replacement)
    Types of AV block:
    According to relation between atrium and ventricle, we can detect three degrees of AV heart
    block:

    First Degree Heart block: slowing of conduction

    Second Degree Heart Block: intermittent interruption of conduction

    Third Degree (Complete) Heart Block: complete interruption of conduction


     In this degree, the electrical signals can’t pass at all from the heart’s upper chamber
    (atria) to its lower chamber (ventricles). In the absence of electrical impulses from the
    sinooatrial node, the ventricles will still contract and pump blood, but at a slower rate
    than usual. So the heart does not contract properly and it can’t pump blood out of the
    body effectively.
     This occurs when no atrial impulse is conducted through the AV node into the ventricles
     Characterized by atrio ventricular dissociation
     Atrial and ventricular activities are unrelated due to complete block of electrical impulses
    to reach the ventricle. This blockage level is infra-nodal (bilateral bundle branches)

    ECG manifestation:
     Dissociation between P wave and QRS
     P wave ay overlap on T wave or QRS complex
     PR interval is not constant
     Rate of rhythm of the atria is about 100 bpm, whereas rate of ventricualr beat is less
    than 40 per minute
     QRS complex usually wide and sometimes normal
    Pathophysiology:

    Clinical manifestation:

     Usually first degree and sometimes second degree are asymtomatic


     The most common signs and symptoms:
    o Severe Bradycardia
    o Hypotension
    o Syncope (Fainting)
    o Chest Pain
    o Dyspnea
    o Dizziness

    Management:

     General management:
     Cardiac monitoring for close observation
     Oxygen supply to manage de saturated patients
     IV line to support blood pressure with fluids
     Atropine standby to treat bradycardia especially incomplete degrees

    Management of heart block depend on symptoms

    First degree heart block:


     This type usually is asymptomatic and not indicated for treatment:
     Just for:
    o Close observation of hemodynamic status
    o Discontinue of some medication that cause bradycardia such as:
     beta blockers (concor) –these drugs inhibits the part of the nervous
    system that speeds up the heart. This can have the side effects of delaying
    electrical conduction within the heart which can cause first degree heart
    block
     digoxins (lanoxine) –this medication slow down the heart rate. If it’s
    taken in high dsages or for a long period, this may cause first degree heart
    block
     calcium channel blockers (diltiazem) –this can slow down the conduction
    within heart’s AV node

    Second degree and complete heart block:

     Usually these degrees are associated with severe bradycardia which can be treated by
    atropine
     Associated conditions should be treated correctly such as:
    o Myocardial infarction
    o Electrolyte disturbance (hyperkalemia)
    o Digitalis intoxification
     Transvenous temporary pacemaker is indicated for patient with severe bradycardia who
    has no effect of atropine administration
     Transcutanous permanent pacemaker is indicated for vhronic AV block

    Nursing diagnosis: (priority)


     Decrease cardiac output related to failure of the heart to pump enough blood to meet
    metabolic needs of the body as manifested by hypotension
     Acute chest Pain related to decrease blood flow to myocardium through coronary arteries
     Ineffective Tissue perfusion related to decrease cardiac output as manifested by patient
    syncope
     Fatigue related to increase hypoxic tissue and slowed removal of metabolic wastes

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