First degree AV block causes: Difference between revisions

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Latest revision as of 04:51, 22 July 2021

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Raviteja Guddeti, M.B.B.S. [3]

Overview

Common causes of first-degree AV block include ischemic heart disease, congenital heart disease, electrolyte abnormalities (particularly hypokalemia and hypomagnesemia), inflammation, infections (endocarditis, rheumatic fever, Chagas disease, Lyme disease, diphtheria), drugs (antiarrhythmic Ia, Ic, II, III, IV and digoxin, β-blockers, calcium channel blockers ), infiltrative diseases (sarcoidosis), collagen vascular diseases (SLE, rheumatoid arthritis, scleroderma), idiopathic degenerative diseases (Lenegre and Lev diseases) and neuromuscular disorders and increased vagal tone in younger patients.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Hyperkalemia
Hyperthyroidism
Hypothyroidism
Increased vagal tone (e.g. sleep, athletes)
Ischemic heart disease
Medications ( e.g. adenosine, amiodarone, beta-blockers, diltiazem, procainamide, verapamil)

Causes by Organ System

Cardiovascular	Acute myocardial infarction, acute rheumatic fever, ASD, dilated cardiomyopathy, Ebstein's anomaly, hypersensitive carotid sinus syndrome, hypertension, hypertrophic cardiomyopathy, Lev's disease, myocardial bridging, myocarditis, post aortic valve replacement, post catheter ablation for arrhythmias, post closure of a ventricular septal defect, post mitral valve replacement, tetralogy of Fallot, endocardial cushion defect, transposition of the great vessels, valvular heart disease, VSD
Chemical / poisoning	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	Amiodarone, beta-blockers, digitalis, calcium channel blockers, cholinesterase inhibitors, disopyramide, dofetilide, dolasetron, donepezil, eslicarbazepine acetate, fesoterodine, fingolimod, flecainide, ibutilide, lacosamide, magnesium, paliperidone, pramipexole, procainamide, propafenone, propoxyphene, quinidine, sotalol, terodiline
Ear Nose Throat	No underlying causes
Endocrine	Hyperthyroidism, myxedema, thyrotoxic periodic paralysis, hypothyroidism
Environmental	Hypothermia
Gastroenterologic	Hemochromatosis
Genetic	Emery-Dreifuss muscular dystrophy, Fabry disease, glycogenosis type 2b, hereditary neuromuscular disease, Kearns-Sayre syndrome
Hematologic	Multiple myeloma
Iatrogenic	Post aortic valve replacement, post catheter ablation for arrhythmias, post closure of a ventricular septal defect, post mitral valve replacement
Infectious Disease	Acute rheumatic fever, Chagas disease, diphtheria, Lyme disease, myocarditis, neonatal lupus erythematosus, protozoal infection, sarcoidosis, SLE, tuberculosis
Musculoskeletal / Ortho	Ankylosing spondylitis, hereditary neuromuscular disease, Kearns-Sayre syndrome, mitochondrial genome inherited conditions, muscular dystrophy
Neurologic	No underlying causes
Nutritional / Metabolic	Fabry disease, glycogenosis type 2b
Obstetric/Gynecologic	No underlying causes
Oncologic	Multiple myeloma
Opthalmologic	No underlying causes
Overdose / Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	Sarcoidosis
Renal / Electrolyte	Hyperkalemia, hypokalemia
Rheum / Immune / Allergy	Ankylosing spondylitis, dermatomyositis, rheumatoid arthritis, scleroderma, SLE
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	No underlying causes
Dental	No underlying causes
Miscellaneous	Amyloidosis, degenerative diseases, enhanced vagal tone, normal variants

Causes in Alphabetical Order

References

Template:WikiDoc Sources

@@ Line 2: / Line 2: @@
 {{First degree AV block}}
 {{CMG}}; {{AE}} {{CZ}}; {{RT}}
-{{SK}}
 ==Overview==
+Common causes of [[first-degree AV block]] include [[ischemic heart disease]], [[congenital heart disease]], [[electrolyte]]  abnormalities (particularly [[hypokalemia]] and [[hypomagnesemia]]), [[inflammation]], [[infections]] ([[endocarditis]], [[rheumatic fever]], [[Chagas disease]], [[Lyme disease]], [[diphtheria]]), [[drugs]] ([[antiarrhythmic ]] Ia, Ic, II, III, IV and [[digoxin]], [[β-blockers]], [[calcium channel blockers]] ), [[infiltrative diseases]] ([[sarcoidosis]]), [[collagen vascular diseases]] ([[SLE]], [[rheumatoid arthritis]], [[scleroderma]]), idiopathic degenerative diseases ([[Lenegre]] and [[Lev diseases]]) and [[neuromuscular disorders]]  and increased [[vagal tone]] in younger [[patients]].
 ==Causes==
 ===Life Threatening Causes===
-Life-threatening conditions  can result in death or permanent disability within 24 hours if left untreated.
+Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
-* [[Myocarditis]]
+*[[Acute myocardial infarction]]
-* Acute [[myocardial infarction]]
+*[[Acute rheumatic fever]]
-* [[Bacterial endocarditis]]
+*[[Bacterial endocarditis]]
-*
+*[[Myocarditis]]
-*
-*
-*
-*
-*
-*
-*
 ===Common Causes===
+*[[Hyperkalemia]]
-Enhanced vagal tone in athletes
+*[[Hyperthyroidism]]
+*[[Hypothyroidism]]
-electrolyte disturbances
+*[[vagus nerve|Increased vagal tone]] (e.g. [[sleep]], athletes)
-[[drugs]]; [[calcium channel blockers]], [[beta-blockers]], [[digitalis]],[[cardiac glycosides]], [[cholinesterase inhibitor|cholinesterase inhibitors]], ** [[Quinidine]] and [[Procainamide]] may produce slight prolongation of the PR,
+*[[Ischemic heart disease]]
-* Normal variants of [[PR prolongation]]
+*Medications ( e.g. [[adenosine]], [[amiodarone]], [[beta-blockers]], [[diltiazem]], [[procainamide]], [[verapamil]])
-* [[Vagal maneuvers]]
-* Acute MI - esp [[inferior MI)
-* Degenerative diseases
-* Idiopathic bilateral bundle branch fibrosis and the heart block is called primary heart block
-* [[Lev's disease]]
-* Hypertension
-* Chronic [[AV block]] in patients with [[HTN]] is thought to be due to [[CAD]] or sclerosis of the left side of the cardiac skeleton exacerbated by
-* [[hypertension]]
-* [[Acute rheumatic fever]]
-* [[Dilated cardiomyopathy]]
-* [[HCM]]: 3% of patients with [[HCM]] will develop heart block
-* [[Myocarditis]]
-* [[SLE]]
-* Tumors, primary and secondary
-* Valvular Heart Disease
-* Calcific [[aortic stenosis]]
-* Rheumatic mitral valve disease
-*  May also be seen in [[bacterial endocarditis]], especially of the [[aortic valve]]
-* [[Ebstein's anomaly]]
- [[transposition of the great vessels]], [[ASD]]s and [[Ebstein's anomaly]]
- [[VSD]],
-[[tetralogy of Fallot]]
-[[endocardial cushion defect]].
 ===Causes by Organ System===
 {|style="width:80%; height:100px" border="1"
 |style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
-|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | AV nodal disease, [[Myocarditis]], Acute [[myocardial infarction]] (especially acute inferior MI), [[Hypertension]], [[Acute rheumatic fever]], [[Dilated cardiomyopathy]], [[HCM]], [[Myocarditis]], [[Valvular heart disease]], [[Transposition of the great vessels]], [[ASD]]s, [[Ebstein's anomaly]], [[VSD]], [[Tetralogy of Fallot]], [[Endocardial cushion defect]], [[Lev's disease]]
+|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Acute myocardial infarction]], [[acute rheumatic fever]], [[ASD]], [[dilated cardiomyopathy]],  [[Ebstein's anomaly]], [[Carotid sinus hypersensitivity|hypersensitive carotid sinus syndrome]], [[hypertension]], [[hypertrophic cardiomyopathy]], [[Lev's disease]], [[myocardial bridging]], [[myocarditis]], [[Aortic valve  replacement|post aortic valve  replacement]], [[catheter ablation|post catheter ablation for arrhythmias]], [[ventricular septal defect surgery|post closure of a ventricular septal defect]], [[mitral valve replacement|post mitral valve replacement]], [[tetralogy of Fallot]], [[endocardial cushion defect]], [[transposition of the great vessels]],  [[valvular heart disease]], [[VSD]]
 |-
 |-bgcolor="LightSteelBlue"
@@ Line 71: / Line 37: @@
 |-bgcolor="LightSteelBlue"
 | '''Drug Side Effect'''
-|bgcolor="Beige"| [[Calcium channel blockers]], [[Beta-blockers]], [[Digitalis]], [[Cardiac glycosides]], [[Cholinesterase inhibitor]]s, [[Quinidine]], [[Procainamide]], [[Disopyramide]], [[Flecainide]], [[Encainide]], [[Propafenone]], [[Amiodarone]], [[Sotalol]], [[Dofetilide]], [[Ibutilide]], [[Magnesium]]
+|bgcolor="Beige"| [[Amiodarone]], [[beta-blockers]], [[digitalis]], [[calcium channel blockers]], [[cholinesterase inhibitor|cholinesterase inhibitors]], [[disopyramide]], [[dofetilide]], [[dolasetron]], [[donepezil]], [[eslicarbazepine acetate]], [[fesoterodine]], [[fingolimod]], [[flecainide]], [[ibutilide]], [[lacosamide]], [[magnesium]], [[paliperidone]], [[pramipexole]], [[procainamide]], [[propafenone]], [[propoxyphene]], [[quinidine]], [[sotalol]], [[terodiline]]
 |-
 |-bgcolor="LightSteelBlue"
@@ Line 79: / Line 45: @@
 |-bgcolor="LightSteelBlue"
 | '''Endocrine'''
-|bgcolor="Beige"| No underlying causes
+|bgcolor="Beige"| [[Hyperthyroidism]], [[myxedema]], [[periodic  paralysis|thyrotoxic periodic paralysis]], [[hypothyroidism]]
 |-
 |-bgcolor="LightSteelBlue"
 | '''Environmental'''
-|bgcolor="Beige"| No underlying causes
+|bgcolor="Beige"| [[Hypothermia]]
 |-
 |-bgcolor="LightSteelBlue"
@@ Line 91: / Line 57: @@
 |-bgcolor="LightSteelBlue"
 | '''Genetic'''
-|bgcolor="Beige"| No underlying causes
+|bgcolor="Beige"| [[Emery-Dreifuss muscular dystrophy]], [[Fabry disease]], [[glycogenosis type 2b]], [[Neuromuscular disease|hereditary neuromuscular disease]], [[Kearns-Sayre syndrome]]
 |-
 |-bgcolor="LightSteelBlue"
 | '''Hematologic'''
-|bgcolor="Beige"| No underlying causes
+|bgcolor="Beige"| [[Multiple myeloma]]
 |-
 |-bgcolor="LightSteelBlue"
 | '''Iatrogenic'''
-|bgcolor="Beige"| No underlying causes
+|bgcolor="Beige"| [[aortic valve  replacement|Post aortic valve  replacement]], [[catheter ablation|post catheter ablation for  arrhythmias]], [[ventricular septal defect surgery|post closure of a  ventricular septal defect]], [[mitral valve  replacement|post mitral valve  replacement]]
 |-
 |-bgcolor="LightSteelBlue"
 | '''Infectious Disease'''
-|bgcolor="Beige"| [[Acute rheumatic fever]], [[Chagas disease]], [[Diphtheria]], [[Lyme disease]], [[Myocarditis]], [[Tuberculosis]]
+|bgcolor="Beige"| [[Acute rheumatic fever]], [[Chagas disease]], [[diphtheria]], [[Lyme disease]], [[myocarditis]], [[neonatal lupus erythematosus]], [[protozoa|protozoal infection]], [[sarcoidosis]], [[SLE]], [[tuberculosis]]
 |-
 |-bgcolor="LightSteelBlue"
 | '''Musculoskeletal / Ortho'''
-|bgcolor="Beige"| [[Ankylosing spondylitis]], [[Muscular dystrophy]]
+|bgcolor="Beige"| [[Ankylosing spondylitis]], [[Neuromuscular disease|hereditary neuromuscular disease]], [[Kearns-Sayre syndrome]], [[mitochondrial disease|mitochondrial genome inherited conditions]],  [[muscular dystrophy]]
 |-
 |-bgcolor="LightSteelBlue"
@@ Line 115: / Line 81: @@
 |-bgcolor="LightSteelBlue"
 | '''Nutritional / Metabolic'''
-|bgcolor="Beige"| No underlying causes
+|bgcolor="Beige"| [[Fabry disease]], [[glycogenosis type 2b]]
 |-
 |-bgcolor="LightSteelBlue"
@@ Line 123: / Line 89: @@
 |-bgcolor="LightSteelBlue"
 | '''Oncologic'''
-|bgcolor="Beige"| No underlying causes
+|bgcolor="Beige"| [[Multiple myeloma]]
 |-
 |-bgcolor="LightSteelBlue"
@@ Line 143: / Line 109: @@
 |-bgcolor="LightSteelBlue"
 | '''Renal / Electrolyte'''
-|bgcolor="Beige"| No underlying causes
+|bgcolor="Beige"| [[Hyperkalemia]], [[hypokalemia]]
-|-
 |-bgcolor="LightSteelBlue"
 | '''Rheum / Immune / Allergy'''
-|bgcolor="Beige"| [[Ankylosing spondylitis]], [[Dermatomyositis]], [[Scleroderma]], [[SLE]], [[Rheumatoid arthritis]]
+|bgcolor="Beige"| [[Ankylosing spondylitis]], [[dermatomyositis]], [[rheumatoid arthritis]], [[scleroderma]], [[SLE]]
 |-
 |-bgcolor="LightSteelBlue"
@@ Line 167: / Line 133: @@
 |-bgcolor="LightSteelBlue"
 | '''Miscellaneous'''
-|bgcolor="Beige"|  [[Amyloidosis]], Enhanced vagal tone (for example in athletes), Normal variants
+|bgcolor="Beige"|  [[Amyloidosis]], [[degenerative diseases]],  [[vagus nerve|enhanced  vagal tone]], [[PR interval|normal variants]]
 |-
 |}
 ===Causes in Alphabetical Order===
-*Acute [[myocardial infarction]] (especially acute inferior MI)
+{{col-begin|width=80%}}
+{{col-break|width=33%}}
+*[[Acute myocardial infarction]]
 *[[Acute rheumatic fever]]
-*[[Amiodarone]]
 *[[Amyloidosis]]
 *[[Ankylosing spondylitis]]
 *[[ASD]]
-*AV nodal disease
+*[[Bacterial endocarditis]]
-*[[Beta-blocker]]s
+*[[Beta-blockers]]
-*[[Calcium channel blocker]]s
+*[[Calcific aortic stenosis]]
+*[[Calcium channel blockers]]
 *[[Cardiac glycosides]]
+*[[Cardiac tumors]]
 *[[Chagas disease]]
-*[[Cholinesterase inhibitor]]s
+*[[Cholinesterase inhibitors]]
+*[[Clonidine]]
+*[[Degenerative diseases]]
 *[[Dermatomyositis]]
 *[[Digitalis]]
+*[[Digoxin]]
 *[[Dilated cardiomyopathy]]
+*[[Diltiazem]]
 *[[Diphtheria]]
 *[[Disopyramide]]
-*[[Dofetilide]]
+*[[Dolasetron]]
+*[[Donepezil]]
+*[[Ebstein anomaly]]
 *[[Ebstein's anomaly]]
-*[[Encainide]]
+*[[Electrolyte disturbances]]
-*[[Endocardial cushion defect]]
+*[[Emery-Dreifuss muscular dystrophy]]
-*Enhanced vagal tone (for example in athletes)
+*[[vagus nerve|Enhanced vagal tone in athletes]]
-*[[Flecainide]]
+{{col-break|width=33%}}
+*[[Eslicarbazepine acetate]]
+*[[Fabry disease]]
+*[[Fesoterodine]]
+*[[Fingolimod]]
+*[[Glycogenosis type 2b]]
 *[[HCM]]
-*[[Hemochromatosis]]
+* [[Neuromuscular disease|Hereditary neuromuscular disease]]
-*[[Hypertension]]
+*[[Hodgkin lymphoma]]
+*[[Hyperkalaemia]]
+*[[Carotid sinus hypersensitivity|Hypersensitive carotid sinus syndrome]]
+*[[Hyperthyroidism]]
+*[[Hypokalaemia]]
+*[[Hypothermia]]
 *[[Ibutilide]]
+*[[Ischaemic heart disease]]
+*[[Kearns-Sayre syndrome]]
+*[[Labetalol]]
+*[[Lacosamide]]
+*[[Lanatoside C]]
+*[[Lenegre's disease]]
 *[[Lev's disease]]
-*[[Lenègre-Lev disease]]
 *[[Lyme disease]]
-*[[Magnesium]]
+*[[Mitochondrial DNA|Mitochondrial genome inherited conditions]]
+*[[Multiple myeloma]]
 *[[Muscular dystrophy]]
+*[[Myocardial bridging]]
 *[[Myocarditis]]
-*Normal variants
+*[[Myotonic dystrophy]]
+*[[Myxedema]]
+{{col-break|width=33%}}
+*[[Neonatal lupus erythematosus]]
+*[[prolonged PR interval|Normal variants of PR  prolongation]]
+*[[Paliperidone]]
+*[[aortic valve  replacement|Post aortic valve replacement ]]
+*[[catheter ablation|Post catheter ablation for  arrhythmias]]
+*[[Ventricular septal defect surgery|Post closure of a  ventricular septal defect]]
+*[[mitral valve  replacement|Post mitral valve  replacement]]
 *[[Procainamide]]
-*[[Propafenone]]
+*[[Propoxyphene]]
+*[[Propranolol]]
+*[[Protozoa|Protozoal infection]]
 *[[Quinidine]]
-*[[Rheumatoid arthritis]]
+*[[Quinine]]
+*[[Rheumatic fever|Rheumatic mitral valve disease]]
 *[[Sarcoidosis]]
-*[[Scleroderma]]
 *[[SLE]]
-*[[Sotalol]]
+*[[Systemic sclerosis]]
+*[[Terodiline]]
 *[[Tetralogy of Fallot]]
-*[[Transposition of the great vessels]]
+*[[periodic  paralysis|Thyrotoxic periodic  paralysis]]
-*[[Tuberculosis]]
+*[[Tolterodine]]
+*[[Transposition of the great  vessels]]
+*[[vagus nerve|Vagal maneuvers]]
+*[[Valsalva maneuver]]
 *[[Valvular heart disease]]
+*[[Verapamil]]
 *[[VSD]]
+*[[sex linkage|X-linked inherited  conditions]]
+{{col-end}}
 ==References==
 {{Reflist|2}}
-{{WikiDoc Help Menu}}
-{{WikiDoc Sources}}
-[[Category:Electrophysiology]]
 [[Category:Cardiology]]
-[[Category:Disease]]
 [[Category:Up-To-Date]]
 [[Category:Up-To-Date cardiology]]
 [[Category:Arrhythmia]]
+[[Category:Electrophysiology]]
 [[Category:Disease]]
-[[Category:Primary care]]
+{{WikiDoc Help Menu}}
+{{WikiDoc Sources}}

First degree AV block causes: Difference between revisions

Latest revision as of 04:51, 22 July 2021

Overview

Causes

Life Threatening Causes

Common Causes

Causes by Organ System

Causes in Alphabetical Order

References

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