Heart block (patient information)

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Heart block

Overview

What are the symptoms?

What are the causes?

Who is at highest risk?

Diagnosis

When to seek urgent medical care?

Treatment options

Where to find medical care for Heart block?

What to expect (Outlook/Prognosis)?

Possible complications

Heart block On the Web

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FDA on Heart block

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Heart block in the news

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Directions to Hospitals Treating Heart block

Risk calculators and risk factors for Heart block

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Varun Kumar, M.B.B.S., Edzel Lorraine Co, DMD, MD[2]

Overview

Heart block is a problem that occurs with the heart's electrical system. This system controls the rate and rhythm of heartbeats. ("Rate" refers to the number of times your heart beats in a minute. "Rhythm" refers to the pattern of regular or irregular pulses produced when the heart beats over time.)

With each heartbeat, an electrical signal spreads across the heart from the upper to the lower chambers. As it travels, the signal causes the heart to contract and pump blood. This process repeats with each new heartbeat.

Heart block occurs if the electrical signal is slowed or disrupted as it moves from the upper to the lower chambers of the heart.

A serious condition will lead to stopping of the heartbeat. If left untreated, the patient may die.

What are the symptoms of Heart block?

Symptoms depend on the type of heart block you have.

First-degree heart block rarely causes symptoms.

Symptoms of second- and third-degree heart block include:

Third degree heart block are more life-threatening than second-degree heart block.

What causes Heart block?

Heart block has many causes. Some people are born with the disorder (congenital), while others develop it during their lifetimes (acquired) either from a disease, medication or surgery.

Congenital Heart Block

Acquired Heart Block

Many factors can cause acquired heart block. Examples include:

In some cases, acquired heart blockmay go away if the factor causing it is treated or resolved. For example, heart block that occurs after a heart attack or surgery may go away during recovery.

Also, if a medication is causing heart block, the disorder may go away if the medication is stopped or the dosage is lowered. Always talk with your doctor before you change the way you take your medications.

Who is at highest risk?

The risk factors for congenital and acquired heart block are different.

Congenital Heart Block

Acquired Heart Block

  • Acquired heart block can occur in people of any age. However, most types of the disorder are more common in older people. This is because many of the risk factors are more common in older people.

Diagnosis

Heart block may be diagnosed as part of a routine doctor's visit or during an emergency situation. (Third-degree heart block often is an emergency.) Your doctor will diagnose heart block based on your family and medical histories, a physical exam, and results from tests such as:

  • EKG (Electrocardiogram): Doctors usually use a test called an EKG (electrocardiogram) to help diagnose heart block. An EKG shows how fast the heart is beating and its rhythm (steady or irregular). The test also records the strength and timing of electrical signals as they pass through each part of the heart.
  • Holter Monitors: A Holter monitor records the heart's electrical signals for a full 24- or 48-hour period. You wear one while you do your normal daily activities. This allows the monitor to record your heart for a longer time than a standard EKG.
  • Event Monitors: An event monitor is similar to a Holter monitor. You wear an event monitor while doing your normal activities. However, an event monitor only records your heart's electrical activity at certain times while you're wearing it.
  • Electrophysiology Study: For some cases of heart block, doctors may do electrophysiology studies (EPS). During this test, a thin, flexible wire is passed through a vein in your groin (upper thigh) or arm to your heart. The wire records your heart's electrical signals.

When to seek urgent medical care?

If you are experiencing the above-mentioned symptoms for the first time or are severe, call 9–1–1 or have someone drive you to the hospital emergency room. If you have milder symptoms, talk with your doctor right away to find out whether you need prompt treatment.

Treatment options

Treatment depends on the type of heart block you have. First-degree heart block usually needs no treatment.

If you have second-degree heart block, you may need a pacemaker. A pacemaker is a small device that's placed under the skin of your chest or abdomen. This device uses electrical pulses to prompt the heart to beat at a normal rate.

If you have third-degree heart block, you will need a pacemaker. In an emergency, a temporary pacemaker may be used until you can get a long-term device. Most people who have third-degree heart block need pacemakers for the rest of their lives.

Some people who have third-degree congenital heart block don't need a pacemaker for many years. Others may need a pacemaker at a young age or during infancy.

If a pregnant woman has an autoimmune disease, such as lupus, her fetus is at risk for heart block. If heart block is detected in a fetus, the mother may be given medicine to reduce the fetus' risk of developing serious heart block.

Sometimes acquired heart block goes away if the factor causing it is treated or resolved. For example, heart block that occurs after a heart attack or surgery may go away during recovery.

Also, if a medicine is causing heart block, the condition may go away if the medicine is stopped or the dosage is lowered. Always talk with your doctor before you change the way you take your medicines.

Medications to avoid

Patients diagnosed with second-degree atrioventricular block and third-degree atrioventricular block should avoid using the following medications:

  • Amiodarone
  • Propafenone
  • Timolol
    If you have been diagnosed with second-degree atrioventricular block and third-degree atrioventricular block, consult your physician before starting or stopping any of these medications.


Where to find medical care for Heart block?

Directions to Hospitals Treating Heart Block

What to expect (Outlook/Prognosis)?

  • First-degree heart block may not cause any symptoms or require treatment.
  • If you have second-degree heart block that doesn't require a pacemaker, talk with your doctor about keeping your heart healthy. Your doctor will tell you whether you need ongoing care for your condition.
  • People who have third-degree heart block and some people who have second-degree heart block need pacemakers. This device uses electrical pulses to prompt the heart to beat at a normal rate.
  • If you have a pacemaker, you should take special care to avoid things that may interfere with it. Avoid close or prolonged contact with electrical devices and devices that have strong magnetic fields. These objects can keep your pacemaker from working properly.
  • Let all of your doctors, dentists, and medical technicians know that you have a pacemaker. You also should notify airport screeners.
  • Your doctor can give you a card that states what kind of pacemaker you have. Carry this card in your wallet. You may want to consider wearing a medical ID bracelet or necklace that states that you have a pacemaker.
  • Certain medical procedures can disrupt pacemakers. Examples include MRI (magnetic resonance imaging), electrocauterization during surgery, and shock-wave lithotripsy to get rid of kidney stones.
  • Your doctor may need to check your pacemaker several times a year to make sure it's working well. Some pacemakers must be checked in the doctor's office, but others can be checked over the phone.
  • Ask your doctor about what types of physical activity are safe for you. A pacemaker usually won't limit you from doing sports and physical activity. But you may need to avoid full-contact sports, such as football, that can damage the pacemaker.

Possible complications

Sources

http://www.nhlbi.nih.gov/health/dci/Diseases/hb/hb_whatis.html


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