AV Heart Block

AV Heart Block – General Information

The AV Heart Block is a medical condition in the electrical system of the heart. It is the opposed phenomenon to the coronary artery disease (this is the disease of the blood vessels which irrigate the heart).
There are four types of AV Heart Block:

• First degree AV Block
• Second degree AV Block
• Type 1 second degree AV Block, which is also known as Wenckebach phenomenon or Mobitz I.
• Type 2 Second degree AV block is also known as Mobitz II.
• Third degree AV Block is also known as the complete heart block.

In the case of the first degree AV Block the impulses which result from the sino-atrial node are conducted very slowly (meaning that the interval is prolonged up to 0,20 seconds) through the AV junction to the ventricles. This is due to the dysfunction of the AV node or a disease of the AV node.
In the case of the second degree AV Block there is blocked conduction between the atria and the ventricles. Type 1 second degree AV Block is a medical condition of the AV node, while Type 2 Second degree AV block is the disease of the His-Purkinje System. In the case of the Third degree AV Block the impulse from the atria does not reach to the ventricles.
The causes of the appearance of the AV Heart Block are the following:

• A congenital defect
• Heart attacks
• Myocarditis –is an inflammation of the muscle of the heart
• Cardiomyopathy
• Heart surgery
• Taking an overdose of certain medicines
• Coronary artery disease

AV Heart Block - Symptoms

• Light-headedness
• Syncope – meaning fainting
• Near syncope
• Palpitations
• Dizziness
• Chest pain, pressure
• Breathlessness
• Fatigue
• Weakness
• Arrhythmia (tachycardia or bradycardia)
• Slow heart beat
• Irregular heart beat such as skipped beats
• Blackouts also known as Stoke Adams Syndrome
• Breathlessness with exertion
• Breathlessness caused by fever
• Heart failure
• Tiredness
• Confusion
• Unsteadiness
• Convulsions
• Collapsing
• Cough
• Fluid accumulation
• Edema
• Swollen legs, feet and ankles
• Lung congestion
• Abnormal weight gain
• Raspy breathing
• Wheezing
• Heart enlargement
• Heart hypertrophy
• Night urinations
• Persistent coughing and sometimes coughing up blood in small quantities.

Usually the first degree AV block and the second degree AV block, including the type 1 and 2 of the second degree AV block cause no symptoms, except the skipped beats, which patients do not notice in the majority of the cases, and this is why many patients are completely asymptomatic.

AV Heart Block - Treatment  

It is well known the fact that AV Heart Block can occur at any age, but it appears more frequently in persons who are in the middle age. The AV Heart Block may be caused by:

• Calcium channel blockers
• Beta blockers
• Adenosine
• Digitals

But it may also be caused by other medical conditions such as endocardytis, myocarditis, Lyme disease, Lenegre disease, Lev disease, coronary heart disease and heart attack.
The AV Heart Block is hard to diagnose as it is unpredictable and brief. In order for it to be diagnose the doctor will take in consideration the patient’s medical history, he will also listen to the patient’s heart, and ask him about the symptoms he has, and submit the patients to an electrocardiogram.
In the case of the treatment, in some cases the heart block may resolve by itself or it may not be bothersome enough to need treatment.  The most frequently used drugs are:

• Isoproterenol
• Atropine – only in the case of the first degree heart block, because in the second and third degree the treatment is usually not responsive.

In the case of the first degree heart block there is usually no treatment required. In the case of the second degree type I heart block the treatment refers to the underlying causes which contribute to it. In the case that the heart beat is too slow, then the patients may be required to take Atropine or pacemakers. In the second degree type II, the treatment is very important, as the patients may develop serious symptoms, and this type has life threatening complications. In third degree AV Heart Block the treatment relies on an artificial pacemaker in order to regulate the electrical activity. In the case that the patients have a complete heart block, then a permanent pacemaker will be inserted, in order to keep the heart beating.
Here is a list of other medications that can be prescribed by your personal health care provider in the case of the AV Heart Block:

• Adrenalin oral
• Adrenalin injections
• Asthmahaler aerosol
• Ana – Guard oral
• Ana-Guard injections which are used as:
• Anesthetic adjunct
• Antiallergic, systemic
• Bronchodilator
• Priapism reversal agent
• Tocolytic agent
• Asthma Nefrin
• Asthmanefrin Nebulizer Solution
• Atreza – is an anticholinergic
• AtroPen
• Atropine Ointment - is an anticholinergic
• Atropine Ophthalmic
• Epi EZ Pen
• Epinephrine Nebulizer Solution
• Epinephrine Ophthalmic
• EpiPen Auto Injector oral
• EpiPen Auto Injector injections
• EpiPen JR auto injector
• Isoproterenol – is used to treat some heart problems such as heart attacks, heart failure, blood vessels problems, irregular heart beats (such as heart block).
• Isoprotenerol oral – is a sympathomimetic
• Isoprotenerol injections – are sympathomimetics

These drugs are not recommended in the following cases:

• patients are allergic to the substances that they contain
• patients are pregnant
• Breastfeeding
• Children
• High blood pressure
• Overactive thyroid
• Pheochromocytoma