eMedicine Specialties > Emergency Medicine > Cardiovascular
Heart Block, First Degree: Differential Diagnoses & Workup
Updated: Mar 9, 2009
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
- Multimedia
Differential Diagnoses
Heart Block, Second Degree
Heart Block, Third Degree
Other Problems to Be Considered
Second-degree AV block
Third-degree AV block (complete heart block)
Junctional escape rhythms
Workup
Laboratory Studies
- Routine laboratory studies are usually not indicated in the evaluation of first-degree atrioventricular (AV) block.
- Electrolyte and drug screen can be obtained if a metabolic derangement or drug toxicity is suspected.
Imaging Studies
- Routine imaging studies are not indicated for first-degree heart block.
Other Tests
- Follow-up ECGs may be indicated in patients who are treated with AV nodal agents while in the ED as well as for patients with a concomitant MI.
Procedures
- In general, no treatment is indicated for first-degree heart block. For those patients with a PR >300 msec, however, several uncontrolled trials have demonstrated an improvement in symptoms with the placement of a dual chamber pacemaker. However, there is little evidence suggesting an improvement in survival.2
More on Heart Block, First Degree |
| Overview: Heart Block, First Degree |
Differential Diagnoses & Workup: Heart Block, First Degree |
| Treatment & Medication: Heart Block, First Degree |
| Follow-up: Heart Block, First Degree |
| Multimedia: Heart Block, First Degree |
| References |
| « Previous Page | Next Page » |
References
John AD, Fleisher LA. Electrocardiography: the ECG. Anesthesiol Clin. Dec 2006;24(4):697-715, v-vi. [Medline].
Barold SS, Ilercil A, Leonelli F, Herweg B. First-degree atrioventricular block. Clinical manifestations, indications for pacing, pacemaker management & consequences during cardiac resynchronization. J Interv Card Electrophysiol. Nov 2006;17(2):139-52. [Medline].
Sherron P, Torres-Arraut E, Tamer D, Garcia OL, Wolff GS. Site of conduction delay and electrophysiologic significance of first-degree atrioventricular block in children with heart disease. Am J Cardiol. May 1 1985;55(11):1323-7. [Medline].
Upshaw CB Jr. Comparison of the prevalence of first-degree atrioventricular block in African-American and in Caucasian patients: an electrocardiographic study III. J Natl Med Assoc. Jun 2004;96(6):756-60. [Medline].
Mymin D, Mathewson FA, Tate RB, Manfreda J. The natural history of primary first-degree atrioventricular heart block. N Engl J Med. Nov 6 1986;315(19):1183-7. [Medline].
Further Reading
Keywords
heart block, first-degree heart block, first degree heart block, arrhythmia, cardiac arrhythmia, abnormal heart rhythm, atrioventricular block, first-degree atrioventricular block, AV block, first-degree AV block, prolongation of the PR interval, P wave, PR interval
Differential Diagnoses & Workup: Heart Block, First Degree