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| Bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1''' [[Thyroid function tests]], [[Lyme]] titer, [[potassium]], pH) based on clinical suspicion for a potential underlying cause is recommended in [[patients]] with [[bradycardia]]'' ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence C]])<nowiki>"</nowiki>''
| Bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1''' [[Thyroid function tests]], [[Lyme]] titer, [[potassium]], pH) based on clinical suspicion for a potential underlying cause is recommended in [[patients]] with [[bradycardia]]'' ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence C]])<nowiki>"</nowiki>''
|}
|}
There are plenty of diagnostic laboratory findings associated with [[third degree AV block]]. Laboratory studies are warranted to diagnose etiologies of secondary heart block such as infections (either bacterial or viral), [[drug toxicity]], and electrolyte abnormalities, and to screen for coincident problems that might either cause or exacerbate a previously presented compensated heart block.
Primary lab work up of patients with [[third degree AV block]] might include but not limitted to the followings:
*[[Complete blood count]] - may reveal [[anemia]] (low RBC count), [[infection]] ([[leukocytosis]] is seen in [[myocarditis]], [[acute rheumatic fever]] and viral infections)
* Differential count
* Serum electrolytes: Particularely [[hyperkalemia]]  and magnesium spescially in selected patients such as those with [[renal insufficiency]]
*[[PT]] and [[aPTT]] may be ordered routinely
* Blood [[Digoxin]] levels should be measured in case of [[digoxin overdose]]
* Myocarditis related studies - HIV serologies, Lyme serology, Chagas serology, enterovirus PCR, adenovirus [[PCR]]
* Peripheral blood smears can aid in the diagnosis of hematological disorders like [[thalassemia major]], [[Hodgkins lymphoma]] etc.,
*In patients with concerning history, toxicological studies for [[digoxin]]-like compounds such as:
:*lily of the valley
:*Oleander
:*Foxglove
:*Bufonidae toads
* Cardiac enzyme levels: if history or [[ECG]] findings are suggestive of active coronary artery disease.


==References==
==References==

Revision as of 07:27, 7 June 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Zand, M.D.[2] Soroush Seifirad, M.D.[3] Raviteja Guddeti, M.B.B.S. [4]

Overview

There is not any recommendation about routine laboratory tests in patients presented with bradycardia or conduction disorder. However, in suspicion of the underlying causes of bradycardia including sepsis, rheumatologic disorder, or thyroid disease specific tests are warranted.

Laboratory Findings

Class IIa
"1 Thyroid function tests, Lyme titer, potassium, pH) based on clinical suspicion for a potential underlying cause is recommended in patients with bradycardia (Level of Evidence C)"

References


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