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AV Block Pathology & Causes Diagnosis Presentation Treatment

1st degree Delay in upper Prolonged PR interval Asymptomatic Remove offending agents
portion of node (> 200 ms) Often associated with Treat underlying condition
(cap) Normal QRS other disease No specific therapy for block
Ischemia No effect on HR needed
Toxins
Drugs
Conduction
disease
2nd degree 1. Regular Often asymptomatic Remove toxins
1. Type I 1. Delay in middle supraventricular When associated with Reduce or stop drug causing
(Wenkebach) portion of node rhythm; Progressive drugs or toxins, fatigue, problem
2. Type II 2. Delay in lower prolongation of PR or dyspnea common Atropine (blocks vagus AV
(Mobitz II) portion of node interval until a beat is Often seen in acute MI node, brings HR/BP up) if
dropped; Cycle is
May cause syncope or acutely symptomatic
Ischemia repetitive, and varies in
Temporary pacing if transient
near syncope
Toxins length; QRS usually
problem
Drugs narrow (normal); DOES
AFFECT HR Permanent pacing if MI and
Cardiomyopathy symptomatic
2. Regular
supraventricular
rhythm; Constant PR
interval (fixed ratio of
blocked/conducted
beats across node);
QRS often widened

3rd degree Similar to other Regular Syncope Immediate intervention


blocks, but more supraventricular rhythm CHF usually needed
serious with no relation of P MI Atropine
Most common waves to QRS Chest pain Epinephrine
with infarction Ventricular rhythm Mental status change Pacing, temporary or
Profound drug slower than (due to poor perfusion) permanent
toxicity supraventricular Remove toxin or drug
Weakness/fatigue
rhythm, called escape
Treat acute ischemia
rhythm
QRS wide if escape
rhythm ventricular, and
narrow if junctional

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