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Potentially life-threatening emergency
Complete atrioventricular block
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Potentially life-threatening emergency

Complete atrioventricular block

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Contributors: Ryan Hoefen MD, PhD
Other Resources UpToDate PubMed

Synopsis

Complete failure of atrial electrical impulse conduction to the ventricles, resulting in disassociation of atrial and ventricular rhythms with reliance upon junctional or ventricular escape to maintain the ventricular rate, generally resulting in significant bradycardia. Etiology includes neonatal lupus, myocarditis, and congenital cardiac defects.

Presentations vary according to age of onset.
  • Cases resulting from neonatal lupus may present in utero or during infancy with main finding of bradycardia. Complications include hydrops fetalis, pericardial effusion, and endocardial fibroelastosis. Episodic murmurs and gallops may be observed in neonates and are associated with high mortality.
  • Roughly 40% of cases are diagnosed at average age of 5. These patients present with syncope, dizziness, and bradycardia. Syncopal events may be fatal, even among asymptomatic patients.
  • Adulthood presentation is characterized by bradycardia, fatigue, syncope, dizziness, dyspnea, palpitations, angina pectoris, and congestive heart failure.
Pacemaker implantation is a treatment option associated with excellent prognosis.

Related topics: First-Degree Atrioventricular Block, Second-Degree Atrioventricular Block

Codes

ICD10CM:
I44.2 – Atrioventricular block, complete

SNOMEDCT:
27885002 – Complete atrioventricular block

Differential Diagnosis & Pitfalls

Best Tests

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Updated: 10/13/2016
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Potentially life-threatening emergency
Complete atrioventricular block
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Complete atrioventricular block (Child) : Dizziness, Bradycardia, Syncope
Copyright © 2019 VisualDx®. All rights reserved.