AV Heart Block

Question 0

First-Degree Heart Block

-Clinical Associations

Answer 0

Disease:
-CAD / MI / Hyperthyroidism
Medications:
-Digoxin / BBs / CCBs

Question 1

First-Degree Heart Block

Answer 1

1. Conduction between the atria and the ventricle is prolonged
2. PR interval is prolonged (normal is .12 to .20)k

Question 2

First-Degree Heart Block

-Clinical Significance

Answer 2

1. Asymptomatic

Question 3

First-Degree Heart Block

-Treatment

Answer 3

1. Rule out causes / check meds

2. Monitor **

Question 4

Second-Degree Heart Block Type I

Answer 4

1. Conduction between the atria and the ventricle becomes progressively prolonged until the heart skips a beat
2. EKG shows:
   - PR interval becomes longer and eventually a QRS complex is missing

Question 5

Second-Degree Heart Block Type I

-Clinical Associations

Answer 5

1. Disease:
   - CAD / MI / Infarction
   - Electrolyte imbalance
2. Meds:
   - Digoxin / BBs

Question 6

Second-Degree Heart Block Type I

-Clinical Significance

Answer 6

1. Possible MI

Question 7

Second-Degree Heart Block Type I

-Treatment if Symptomatic

Answer 7

1. Atropine
   or
   2.Temporary pacemaker

Question 8

Second-Degree Heart Block Type I

-If Asymptomatic

Answer 8

1. MONITOR w/ transcutaneous pacemaker on standby

Question 9

Second-Degree Heart Block Type II

Answer 9

1. The conduction from the atria does not always reach the ventricles
2. On EKG: PR interval is the same, QRS complex is sometimes missing

Question 10

Second-Degree Heart Block Type II

-Clinical Associations

Answer 10

1. Disease
   - Rheumatic Heart Dz / CAD / MI
2. Meds
   - Digoxin Toxicity

Question 11

Second-Degree Heart Block Type II

-Clinical Significance

Answer 11

1. Often progresses to third-degree AV block and associated with poor prognosis
2. Reduced HR results in decreased CO w/ subsequent hypotension and MI

Question 12

Second-Degree Heart Block Type II

-Treatment

Answer 12

1. Permanent Pacemaker ASAP

Question 13

Second-Degree Heart Block Type II

-Treatment if Symptomatic

Answer 13

1. If Hypotension or angina are present use temporary transvenous or transcutaneous pacemaker before permanent pacemaker is inserted

Question 14

Third-Degree AV Heart Block

Answer 14

1. Form of AV dissociation in which no impulses from the atria are conducted to the ventricles
   - Atria are stimulated and contract independently of ventricles
2. Ventricular rhythm is an escape rhythm
   - ectopic pacemaker

Question 15

Third-Degree AV Heart Block

-EKG presentation

Answer 15

1. P waves and QRS complexes occur independent of each other (different rates)

Question 16

Third-Degree AV Heart Block

-Clinical Associations

Answer 16

1. Disease:
   - CAD / MI / Myocarditis / Cardiomyopathy
2. Drugs:
   - Digoxin / BBs / CCBs

Question 17

Third-Degree AV Heart Block

-Clinical Significance

Answer 17

1. Decreased CO w/ subsequent ischemia, HF, and shock

2. Syncope may result from severe bradycardia or even periods of asystole

Question 18

Third-Degree AV Heart Block

-Treatment if Symptomatic

Answer 18

1. Transcutaneous pacemaker until a temporary transvenous pacemaker can be inserted
2. Drugs to increase HR and BP
3. Permanent Pacemaker ASAP