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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: Young Ju Esther Lee MD, Ryan Hoefen MD, PhD
Other Resources UpToDate PubMed

Synopsis

Complete atrioventricular (AV) block is a failure of atrial electrical impulse conduction to reach the ventricles. This may be persistent or paroxysmal and is associated with a junctional or ventricular escape rhythm. This results in significant bradycardia and a lack of coordinated atrial and ventricular contraction, which can significantly decrease cardiac output. Intermittent complete AV block can cause syncope or presyncope.

Etiologies include neonatal lupus erythematosus, congenital cardiac defects, myocarditis, rheumatic fever, Lyme carditis, bacterial endocarditis, myocardial ischemia, and infiltrative cardiomyopathy due to amyloidosis, sarcoidosis, systemic sclerosis, or systemic lupus erythematosus. Some AV nodal blocking medications such as beta blockers, non-dihydropyridine calcium channel blockers, and digoxin may also cause complete AV block. Manipulations such as cardiac surgery, central venous catheter placement, percutaneous coronary intervention, catheter ablation, percutaneous valve intervention, and alcohol septal ablation can cause complete AV block. Some cases are idiopathic.

Presentations vary with the age of onset. Congenital complete heart block is generally irreversible. Cases resulting from neonatal lupus may present in utero or during infancy. Complications can include hydrops fetalis, pericardial effusion, and endocardial fibroelastosis.

Related topics: first-degree atrioventricular block, second-degree atrioventricular block

Codes

ICD10CM:
I44.2 – Atrioventricular block, complete

SNOMEDCT:
27885002 – Complete atrioventricular block

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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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 Reviewed: 04/10/2020
Last Updated: 05/19/2020
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Potentially life-threatening emergency
Complete atrioventricular block
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View all Images (5)
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Complete atrioventricular block (Child) : Fatigue, Bradycardia, Irritability
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