Third-degree heart block
or complete heart block
- Complete Heart Block
occurs when the two parts of the heart do not beat together.
The problem is with the electrical system of the heart.
- The normal heart has two main parts, the atria and the ventricles. The way that a normal heart beats is via an electrical signal. The signal starts at the atria and goes to the ventricles through a specific electrical pathway. In Complete Heart Block,
there is a problem with the electrical connection -- and the
signal does not go all the way through. Basically, the atria
cannot communicate with the ventricles. This causes problems
such as dizziness, trouble breathing, fainting, chest pain,
etc. Treatment is usually with an electrical device called a
- Symptoms can be quite varied.
They include dizziness, slow heartbeat, fainting, shortness
of breath, chest pain, trouble exercising, and weakness.
- Some people may not have any
symptoms at all.
- Examination may reveal:
- Heart sounds that keep changing
- Blood pressure fluctuations
- Large difference between the
systolic and diastolic pressures
- Large pulsations in the neck
- The cause of this disease is a
problem with the electrical system of the heart (see above).
- The exact cause of the problem is
often not known. The most common cause in older people is
degenerative changes in the electrical system due to old
- Other causes include infections of the heart, traumatic injury to the heart, diseases such as Sarcoidosis or Amyloidosis, poor blood supply to the heart, heart attack, Rheumatoid Arthritis, and medication overdose (i.e., Digoxin, beta blockers, or Calcium-channel
- EKG -- will easily reveal Complete Heart Block.
- Once the diagnosis is made, then
other tests can be done to see what caused the problem. In
older people, it is presumed that the problem is due to old
age, eliminating the necessity for much additional testing.
However, if a young person has this problem, then additional
tests will need to be done to determine the cause. Patients
will need to discuss this with their cardiologist.
- There are no specific risk factors
other than old age, having heart disease, or taking certain
medications. Also, infection of the heart is a risk factor.
- Pacemaker -- is a device that sends
an electrical signal to the heart and makes it beat at a
certain rate. The rate is set by the doctor.
- If a permanent pacemaker cannot be
put in immediately, then a temporary transcutaneous one can
- A transcutaneous pacemaker is
attached to the skin and sends the signal through the skin
to the heart. This is only a temporary solution.
- A permanent pacemaker is usually
placed in the chest wall, with wires going directly into the
heart. The pacemaker then sends the proper electrical
signals to the heart via these wires.
- Other causes of Complete Heart Block
have to be treated appropriately -- infections require
medication, heart disease may require surgery or
- If medications are causing the
problem, they will have to be stopped.
- This is a medical emergency. Seek
immediate medical attention or call
- There is no specific way to prevent this problem.
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