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Complete Heart Block

more about Complete Heart Block

Third-degree heart block or atrioventricular dissociation

  • 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 pacemaker.

  • 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:
    1. Heart sounds that keep changing in intensity
    2. Blood pressure fluctuations (considerable)
    3. Large difference between the systolic and diastolic pressures
    4. 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 age.
  • 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 blockers).

  • 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 be used.
  • 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 angioplasty, etc.
  • If medications are causing the problem, they will have to be stopped.

  • See symptoms

  • This is a medical emergency. Seek immediate medical attention or call 911.

  • There is no specific way to prevent this problem.

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