First degree AV block history and symptoms: Difference between revisions
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=== History === | === History === | ||
*In [[patients]] presented with [[symptoms]] suspicious for [[bradycardia]] or [[conduction disorder]], comprehensive [[history]] should be taken about: | *In [[patients]] presented with [[symptoms]] suspicious for [[bradycardia]] or [[conduction disorder]], comprehensive [[history]] should be taken about:<ref name="KusumotoSchoenfeld2019">{{cite journal|last1=Kusumoto|first1=Fred M.|last2=Schoenfeld|first2=Mark H.|last3=Barrett|first3=Coletta|last4=Edgerton|first4=James R.|last5=Ellenbogen|first5=Kenneth A.|last6=Gold|first6=Michael R.|last7=Goldschlager|first7=Nora F.|last8=Hamilton|first8=Robert M.|last9=Joglar|first9=José A.|last10=Kim|first10=Robert J.|last11=Lee|first11=Richard|last12=Marine|first12=Joseph E.|last13=McLeod|first13=Christopher J.|last14=Oken|first14=Keith R.|last15=Patton|first15=Kristen K.|last16=Pellegrini|first16=Cara N.|last17=Selzman|first17=Kimberly A.|last18=Thompson|first18=Annemarie|last19=Varosy|first19=Paul D.|title=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|journal=Circulation|volume=140|issue=8|year=2019|issn=0009-7322|doi=10.1161/CIR.0000000000000628}}</ref> | ||
::*Timing, [[duration]], [[severity]], [[longevity]], [[circumstances]], [[triggers]] and [[alleviating]] factors of [[symptoms]] | ::*Timing, [[duration]], [[severity]], [[longevity]], [[circumstances]], [[triggers]] and [[alleviating]] factors of [[symptoms]] | ||
::* The relationship of the [[symptoms]] to [[medications]], [[meals]], [[medical interventions]], [[emotional]] distress, [[physical exertion]], [[positional changes]], and triggers (eg, [[urination]], [[defecation]], [[cough]], [[prolonged]] [[standing]], [[shaving]]) | ::* The relationship of the [[symptoms]] to [[medications]], [[meals]], [[medical interventions]], [[emotional]] distress, [[physical exertion]], [[positional changes]], and triggers (eg, [[urination]], [[defecation]], [[cough]], [[prolonged]] [[standing]], [[shaving]]) | ||
::* systemic [[illness]] or [[heart]] disease | ::* systemic [[illness]] or [[heart]] disease | ||
::* [[cardiovascular]] risk assessment, [[family history]], [[travel history]], and review of [[systems]] | ::* [[cardiovascular]] risk assessment, [[family history]], [[travel history]], and review of [[systems]] | ||
=== Symptoms === | === Symptoms === | ||
::*[[Symptoms]] related to [[atrioventricular block]] vary and related to the degree of [[atrioventricular block]], the [[ventricular rate]], and the frequency of its occurrence. *Common [[symptoms]] associate with profound [[first-degree atrioventricular block]] with [[PR interval]] >300 ms include: | ::*[[Symptoms]] related to [[atrioventricular block]] vary and related to the degree of [[atrioventricular block]], the [[ventricular rate]], and the frequency of its occurrence. *Common [[symptoms]] associate with profound [[first-degree atrioventricular block]] with [[PR interval]] >300 ms include: | ||
Revision as of 05:12, 15 July 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Zand, M.D.[2] Ahmed Elsaiey, MBBCH [3]
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
- In patients presented with symptoms suspicious for bradycardia or conduction disorder, comprehensive history should be taken about:[1]
- Timing, duration, severity, longevity, circumstances, triggers and alleviating factors of symptoms
- The relationship of the symptoms to medications, meals, medical interventions, emotional distress, physical exertion, positional changes, and triggers (eg, urination, defecation, cough, prolonged standing, shaving)
- systemic illness or heart disease
- cardiovascular risk assessment, family history, travel history, and review of systems
Symptoms
- Symptoms related to atrioventricular block vary and related to the degree of atrioventricular block, the ventricular rate, and the frequency of its occurrence. *Common symptoms associate with profound first-degree atrioventricular block with PR interval >300 ms include:
- Fatigue
- Exertional intolerance
- Pseudo pacemaker syndrome is defined when the PR interval is >300ms leading to loss of atrioventricular synchrony and decrease in cardiac output and an increase pulmonary capillary wedge pressure.
Reference
- ↑ Kusumoto, Fred M.; Schoenfeld, Mark H.; Barrett, Coletta; Edgerton, James R.; Ellenbogen, Kenneth A.; Gold, Michael R.; Goldschlager, Nora F.; Hamilton, Robert M.; Joglar, José A.; Kim, Robert J.; Lee, Richard; Marine, Joseph E.; McLeod, Christopher J.; Oken, Keith R.; Patton, Kristen K.; Pellegrini, Cara N.; Selzman, Kimberly A.; Thompson, Annemarie; Varosy, Paul D. (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). doi:10.1161/CIR.0000000000000628. ISSN 0009-7322.