First 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: Ahmed Elsaiey, MBBCH [2]

Overview

First degree AV block patients are usually asymptomatic at rest. In the setting of left ventricular dysfunction markedly prolonged PR interval can cause exercise intolerance and syncope.

History and symptoms

History

  • Patients with first degree AV block are usually asymptomatic.
  • History of advanced Lyme disease may be associated with the presentation. Carditis in Lyme disease is associated with first degree AV block.[1]
  • History of systemic lupus erythematosus (SLE) is associated with first degree AV block and can be underlying for an advanced cardiac complication in SLE.[2]
  • History of myocarditis or myocardial infarction is also associated with AV block presentation.

Symptoms

Common symptoms associated with first degree AV block include the following:

  • Syncope: usually result form the temporary higher degree heart block especially in patients with wide QRS complex.

Reference

  1. Costello JM, Alexander ME, Greco KM, Perez-Atayde AR, Laussen PC (2009). "Lyme carditis in children: presentation, predictive factors, and clinical course". Pediatrics. 123 (5): e835–41. doi:10.1542/peds.2008-3058. PMID 19403477.
  2. Makaryus JN, Catanzaro JN, Goldberg S, Makaryus AN (2008). "Rapid progression of atrioventricular nodal blockade in a patient with systemic lupus erythematosus". Am J Emerg Med. 26 (8): 967.e5–7. doi:10.1016/j.ajem.2008.02.010. PMID 18926371.

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