Second degree AV block causes: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Second degree AV block}} | {{Second degree AV block}} | ||
{{CMG}}; {{AE}} {{CZ}} {{MS}} | {{CMG}}; {{AE}} {{CZ}}; {{MS}} | ||
==Overview== | ==Overview== | ||
Common causes of second degree [[AV block]] include acute [[myocardial ischemia]] or [[infarction]], [[infiltrative]] diseases, [[collagen vascular disease]], [[surgical trauma]], [[endocrine]] abnormalities, [[autonomic]] effects, [[neuromuscular ]] disorders, and [[medication]]s. | |||
==Causes== | ==Causes== | ||
===Life Threatening Causes=== | ===Life Threatening Causes=== | ||
Life-threatening conditions can result in death or permanent disability within 24 hours if left untreated. | Life-threatening conditions can result in death or permanent disability within 24 hours if left untreated<ref name="pmid29493981">{{cite journal |vauthors=Mangi MA, Jones WM, Napier L |title= |journal= |volume= |issue= |pages= |date= |pmid=29493981 |doi= |url=}}</ref>. | ||
* [[Acute myocardial infarction]] | * [[Acute myocardial infarction]]<ref name="pmid30227965">{{cite journal |vauthors=Misumida N, Ogunbayo GO, Kim SM, Abdel-Latif A, Ziada KM, Elayi CS |title=Frequency and Significance of High-Degree Atrioventricular Block and Sinoatrial Node Dysfunction in Patients With Non-ST-Elevation Myocardial Infarction |journal=Am. J. Cardiol. |volume=122 |issue=10 |pages=1598–1603 |date=November 2018 |pmid=30227965 |doi=10.1016/j.amjcard.2018.08.001 |url=}}</ref><ref name="pmid23224264">{{cite journal |vauthors=Barold SS, Herweg B |title=Second-degree atrioventricular block revisited |journal=Herzschrittmacherther Elektrophysiol |volume=23 |issue=4 |pages=296–304 |date=December 2012 |pmid=23224264 |doi=10.1007/s00399-012-0240-8 |url=}}</ref> | ||
* [[Acute rheumatic fever]] | * [[Acute rheumatic fever]] | ||
* [[Bacterial endocarditis]] | * [[Bacterial endocarditis]] | ||
| Line 17: | Line 17: | ||
===Common Causes=== | ===Common Causes=== | ||
* [[Acute rheumatic fever]] | * [[Acute rheumatic fever]] | ||
* [[Bacterial endocarditis]] | * [[Bacterial endocarditis]]<ref name="pmid27585419">{{cite journal |vauthors=Kamatani T, Akizuki A, Kondo S, Shirota T |title=Second-Degree Atrioventricular Block Occurring After Tooth Extraction |journal=Anesth Prog |volume=63 |issue=3 |pages=156–9 |date=Fall 2016 |pmid=27585419 |pmc=5011958 |doi=10.2344/15-00042.1 |url=}}</ref> | ||
* [[aortic stenosis|Calcific aortic stenosis]] | * [[aortic stenosis|Calcific aortic stenosis]] | ||
* [[Digoxin]] | * [[Digoxin]] | ||
* [[Dilated cardiomyopathy]] | * [[Dilated cardiomyopathy]] | ||
* [[Diltiazem]] | * [[Diltiazem]] | ||
* [[ | * [[Vasovagal syncope#Cardioinhibitory Response|Enhanced vagal tone]] | ||
* [[HCM]] | * [[HCM]] | ||
* [[Hypertension]] | * [[Hypertension]] | ||
| Line 30: | Line 29: | ||
* [[mitral valve sclerosis|Massive calcification of the mitral annulus]] | * [[mitral valve sclerosis|Massive calcification of the mitral annulus]] | ||
* [[Myocarditis]] | * [[Myocarditis]] | ||
* [[PR interval|Normal variants]] | * [[PR interval|Normal variants]]<ref name="pmid8445186">{{cite journal |vauthors=Wogan JM, Lowenstein SR, Gordon GS |title=Second-degree atrioventricular block: Mobitz type II |journal=J Emerg Med |volume=11 |issue=1 |pages=47–54 |date=1993 |pmid=8445186 |doi=10.1016/0736-4679(93)90009-v |url=}}</ref> | ||
* [[chest trauma|Penetrating and non-penetrating trauma of the chest]] | * [[chest trauma|Penetrating and non-penetrating trauma of the chest]] | ||
* [[Lev's disease|Sclerodegenerative disease of the electrical conduction system]] | * [[Lev's disease|Sclerodegenerative disease of the electrical conduction system]] | ||
| Line 39: | Line 38: | ||
{|style="width:80%; height:100px" border="1" | {|style="width:80%; height:100px" border="1" | ||
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular''' | |style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular''' | ||
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" |[[Acute myocardial infarction]], [[acute rheumatic fever]], [[ASD]], [[dilated cardiomyopathy]], | |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]], [[PR interval|normal variants]], [[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" | |-bgcolor="LightSteelBlue" | ||
| Line 51: | Line 50: | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Drug Side Effect''' | | '''Drug Side Effect''' | ||
|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]], [[procainamide]], [[propafenone]], [[propoxyphene]], [[quinidine]], [[sotalol]], [[terodiline]] | |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" | |-bgcolor="LightSteelBlue" | ||
| Line 75: | Line 74: | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Hematologic''' | | '''Hematologic''' | ||
|bgcolor="Beige"| [[Multiple myeloma]] | |bgcolor="Beige"| [[Multiple myeloma]] [[Lymphoma]]<ref name="pmid27200273">{{cite journal |vauthors=Menicagli F, Lanza A, Sbrocca F, Baldi A, Spugnini EP |title=A case of advanced second-degree atrioventricular block in a ferret secondary to lymphoma |journal=Open Vet J |volume=6 |issue=1 |pages=68–70 |date=2016 |pmid=27200273 |pmc=4833871 |doi=10.4314/ovj.v6i1.10 |url=}}</ref> | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| Line 87: | Line 86: | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Musculoskeletal / Ortho''' | | '''Musculoskeletal / Ortho''' | ||
|bgcolor="Beige"| [[Ankylosing spondylitis]], [[Neuromuscular disease|hereditary neuromuscular disease]], [[Kearns-Sayre syndrome]], [[mitochondrial DNA|mitochondrial genome inherited conditions]], | |bgcolor="Beige"| [[Ankylosing spondylitis]], [[Neuromuscular disease|hereditary neuromuscular disease]], [[Kearns-Sayre syndrome]], [[mitochondrial DNA|mitochondrial genome inherited conditions]], [[muscular dystrophy]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Neurologic''' | | '''Neurologic''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Vasovagal syncope#Cardioinhibitory Response|Enhanced vagal tone]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| Line 147: | Line 146: | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Miscellaneous''' | | '''Miscellaneous''' | ||
|bgcolor="Beige"| [[Amyloidosis]], [[degenerative diseases | |bgcolor="Beige"| [[Amyloidosis]], [[degenerative diseases]] | ||
|- | |- | ||
|} | |} | ||
| Line 178: | Line 177: | ||
* [[Dolasetron]] | * [[Dolasetron]] | ||
* [[Donepezil]] | * [[Donepezil]] | ||
* [[Ebstein's anomaly]] | * [[Ebstein's anomaly]] | ||
* [[Electrolyte disturbances]] | * [[Electrolyte disturbances]] | ||
* [[Emery-Dreifuss muscular dystrophy | * [[Emery-Dreifuss muscular dystrophy]] | ||
* [[Endocarditis]] | * [[Endocarditis]] | ||
* [[vagus nerve| | * [[vagus nerve|Enhanced vagal tone in athletes]] | ||
{{col-break|width=33%}} | |||
* [[Eslicarbazepine acetate]] | * [[Eslicarbazepine acetate]] | ||
* [[Fabry disease]] | * [[Fabry disease]] | ||
* [[Fesoterodine]] | * [[Fesoterodine]] | ||
| Line 191: | Line 189: | ||
* [[Glycogenosis type 2b]] | * [[Glycogenosis type 2b]] | ||
* [[HCM]] | * [[HCM]] | ||
* [[Neuromuscular disease| | * [[Neuromuscular disease|Hereditary neuromuscular disease]] | ||
* [[Hodgkin lymphoma]] | * [[Hodgkin lymphoma]] | ||
* [[Hyperkalaemia]] | * [[Hyperkalaemia]] | ||
| Line 199: | Line 197: | ||
* [[Hypothermia]] | * [[Hypothermia]] | ||
* [[Ibutilide]] | * [[Ibutilide]] | ||
* [[ | * [[Ischemic heart disease]] | ||
* [[Kearns-Sayre syndrome]] | * [[Kearns-Sayre syndrome]] | ||
* [[Labetalol]] | * [[Labetalol]] | ||
| Line 214: | Line 212: | ||
* [[Myotonic dystrophy]] | * [[Myotonic dystrophy]] | ||
* [[Myxedema]] | * [[Myxedema]] | ||
* [[ | {{col-break|width=33%}} | ||
* [[prolonged PR interval|Normal variants of PR | * [[Neonatal lupus erythematosus]] | ||
* [[prolonged PR interval|Normal variants of PR prolongation]] | |||
* [[Paliperidone]] | * [[Paliperidone]] | ||
* [[aortic valve replacement|Post aortic valve replacement]] | |||
* [[aortic valve replacement|Post aortic valve replacement ]] | |||
* [[catheter ablation|Post catheter ablation for arrhythmias]] | * [[catheter ablation|Post catheter ablation for arrhythmias]] | ||
* [[Ventricular septal defect surgery|Post closure of a ventricular septal defect]] | * [[Ventricular septal defect surgery|Post closure of a ventricular septal defect]] | ||
* [[mitral valve replacement|Post mitral valve replacement]] | * [[mitral valve replacement|Post mitral valve replacement]] | ||
* [[Procainamide ]] | * [[Procainamide]] | ||
* [[Propoxyphene]] | * [[Propoxyphene]] | ||
* [[Propranolol]] | * [[Propranolol]] | ||
| Line 232: | Line 229: | ||
* [[Sarcoidosis]] | * [[Sarcoidosis]] | ||
* [[SLE]] | * [[SLE]] | ||
* [[Systemic sclerosis]] | * [[Systemic sclerosis]] | ||
* [[Terodiline]] | * [[Terodiline]] | ||
* [[Tetralogy of | * [[Tetralogy of Fallot]] | ||
* [[periodic paralysis|Thyrotoxic periodic | * [[periodic paralysis|Thyrotoxic periodic paralysis]] | ||
* [[Tolterodine]] | * [[Tolterodine]] | ||
* [[Transposition of the great | * [[Transposition of the great vessels]] | ||
* [[vagus nerve|Vagal maneuvers]] | * [[vagus nerve|Vagal maneuvers]] | ||
* [[Valsalva | * [[Valsalva maneuvers]] | ||
* [[Valvular heart disease]] | * [[Valvular heart disease]] | ||
* [[Verapamil]] | * [[Verapamil]] | ||
| Line 247: | Line 242: | ||
* [[sex linkage|X-linked inherited conditions]] | * [[sex linkage|X-linked inherited conditions]] | ||
{{col-end}} | {{col-end}} | ||
===Contraindicated medications=== | |||
{{MedCondContrAbs | |||
|MedCond = Second degree AV block (except in [[patients]] with a functioning artificial [[pacemaker]])<ref name="pmid26115830">{{cite journal |vauthors=Brignole M, Deharo JC, Guieu R |title=Syncope and Idiopathic (Paroxysmal) AV Block |journal=Cardiol Clin |volume=33 |issue=3 |pages=441–7 |date=August 2015 |pmid=26115830 |doi=10.1016/j.ccl.2015.04.012 |url=}}</ref><ref name="pmid11229299">{{cite journal |vauthors=Kelkar PN |title=Atenolol induced high grade AV block |journal=J Assoc Physicians India |volume=46 |issue=8 |pages=748, 751 |date=August 1998 |pmid=11229299 |doi= |url=}}</ref>|Adenosine|Atenolol|Betaxolol|Bisoprolol|Brimonidine tartrate and Timolol maleate|Carteolol|Diltiazem|Disopyramide|Dronedarone|Fingolimod|Flecainide|Metoprolol|Mexiletine|Nadolol|Nebivolol|Penbutolol|Pindolol|Propranolol|Sotalol|Timolol|Labetalol}}<ref name="pmid15234417">{{cite journal |vauthors=Zeltser D, Justo D, Halkin A, Rosso R, Ish-Shalom M, Hochenberg M, Viskin S |title=Drug-induced atrioventricular block: prognosis after discontinuation of the culprit drug |journal=J. Am. Coll. Cardiol. |volume=44 |issue=1 |pages=105–8 |date=July 2004 |pmid=15234417 |doi=10.1016/j.jacc.2004.03.057 |url=}}</ref> | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
[[Category:Up-To-Date]] | [[Category:Up-To-Date]] | ||
[[Category:Up-To-Date cardiology]] | [[Category:Up-To-Date cardiology]] | ||
[[Category:Arrhythmia]] | [[Category:Arrhythmia]] | ||
[[Category:Electrophysiology]] | |||
[[Category:Disease]] | [[Category:Disease]] | ||
{{WikiDoc Help Menu}} | |||
{{WikiDoc Sources}} | |||
Latest revision as of 05:40, 12 July 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Mahmoud Sakr, M.D. [3]
Overview
Common causes of second degree AV block include acute myocardial ischemia or infarction, infiltrative diseases, collagen vascular disease, surgical trauma, endocrine abnormalities, autonomic effects, neuromuscular disorders, and medications.
Causes
Life Threatening Causes
Life-threatening conditions can result in death or permanent disability within 24 hours if left untreated[1].
- Acute myocardial infarction[2][3]
- Acute rheumatic fever
- Bacterial endocarditis
- Myocarditis
- Severe hypothermia
Common Causes
- Acute rheumatic fever
- Bacterial endocarditis[4]
- Calcific aortic stenosis
- Digoxin
- Dilated cardiomyopathy
- Diltiazem
- Enhanced vagal tone
- HCM
- Hypertension
- Iatrogenic after surgical correction of VSD, tetralogy of Fallot, and endocardial cushion defect
- Inferior ST elevation MI
- Massive calcification of the mitral annulus
- Myocarditis
- Normal variants[5]
- Penetrating and non-penetrating trauma of the chest
- Sclerodegenerative disease of the electrical conduction system
- Verapamil
- β blockers
Causes by Organ System
Causes in Alphabetical Order
Contraindicated medications
Second degree AV block (except in patients with a functioning artificial pacemaker)[7][8] is considered an absolute contraindication to the use of the following medications:
- Adenosine
- Atenolol
- Betaxolol
- Bisoprolol
- Brimonidine tartrate and Timolol maleate
- Carteolol
- Diltiazem
- Disopyramide
- Dronedarone
- Flecainide
- Metoprolol
- Mexiletine
- Nadolol
- Nebivolol
- Penbutolol
- Pindolol
- Propranolol
- Sotalol
- Timolol
- Labetalol[9]
References
- ↑ Mangi MA, Jones WM, Napier L. PMID 29493981. Missing or empty
|title=(help) - ↑ Misumida N, Ogunbayo GO, Kim SM, Abdel-Latif A, Ziada KM, Elayi CS (November 2018). "Frequency and Significance of High-Degree Atrioventricular Block and Sinoatrial Node Dysfunction in Patients With Non-ST-Elevation Myocardial Infarction". Am. J. Cardiol. 122 (10): 1598–1603. doi:10.1016/j.amjcard.2018.08.001. PMID 30227965.
- ↑ Barold SS, Herweg B (December 2012). "Second-degree atrioventricular block revisited". Herzschrittmacherther Elektrophysiol. 23 (4): 296–304. doi:10.1007/s00399-012-0240-8. PMID 23224264.
- ↑ Kamatani T, Akizuki A, Kondo S, Shirota T (Fall 2016). "Second-Degree Atrioventricular Block Occurring After Tooth Extraction". Anesth Prog. 63 (3): 156–9. doi:10.2344/15-00042.1. PMC 5011958. PMID 27585419.
- ↑ Wogan JM, Lowenstein SR, Gordon GS (1993). "Second-degree atrioventricular block: Mobitz type II". J Emerg Med. 11 (1): 47–54. doi:10.1016/0736-4679(93)90009-v. PMID 8445186.
- ↑ Menicagli F, Lanza A, Sbrocca F, Baldi A, Spugnini EP (2016). "A case of advanced second-degree atrioventricular block in a ferret secondary to lymphoma". Open Vet J. 6 (1): 68–70. doi:10.4314/ovj.v6i1.10. PMC 4833871. PMID 27200273.
- ↑ Brignole M, Deharo JC, Guieu R (August 2015). "Syncope and Idiopathic (Paroxysmal) AV Block". Cardiol Clin. 33 (3): 441–7. doi:10.1016/j.ccl.2015.04.012. PMID 26115830.
- ↑ Kelkar PN (August 1998). "Atenolol induced high grade AV block". J Assoc Physicians India. 46 (8): 748, 751. PMID 11229299.
- ↑ Zeltser D, Justo D, Halkin A, Rosso R, Ish-Shalom M, Hochenberg M, Viskin S (July 2004). "Drug-induced atrioventricular block: prognosis after discontinuation of the culprit drug". J. Am. Coll. Cardiol. 44 (1): 105–8. doi:10.1016/j.jacc.2004.03.057. PMID 15234417.