Second-Degree Atrioventricular Block Clinical Presentation

Updated: Jan 26, 2017
  • Author: Ali A Sovari, MD, FACP, FACC; Chief Editor: Jeffrey N Rottman, MD  more...
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Presentation

History and Physical Examination

In patients with Mobitz I second-degree atrioventricular (AV) block, symptoms may vary substantially, ranging from an absence of symptoms in well-trained athletes and persons without structural heart disease to recurrent syncope, presyncope, and bradycardia in patients with heart disease.

Most patients are asymptomatic. Patients may experience light-headedness, dizziness, or syncope, but these symptoms are uncommon. Patients may have chest pain if the heart block is related to myocarditis or ischemia. Patients may have a history of structural heart disease.

In contrast to patients with Mobitz I AV block, those with Mobitz II AV block are more likely to experience light-headedness, dizziness, or syncope, though they may be asymptomatic as well. Patients may have chest pain if the heart block is related to myocarditis or ischemia.

Patients often have a regularly irregular heartbeat. Bradycardia may be present. Symptomatic patients may have signs of hypoperfusion, including hypotension.