Heart block: types, causes, symptoms, treatment

Heart block is a disruption in the electrical signals that control the heart.

Your heart relies on a constant flow of electrical signals that start in the heart’s upper chambers (atria). The signals then travel through the lower heart chambers (ventricles), triggering the ventricles to pump blood from the heart to the lungs and the rest of the body. Heart block occurs when there is interference in this electrical activity between the atria and ventricles.

A heart block is usually the result of a heart attack or other injury to the heart, but it can have other causes. If the heart block is minor, treatment may not be necessary. If it is more severe, a pacemaker may be needed to restore healthy electrical activity in the heart.

Read on to learn more about types of heart block, causes, symptoms to look out for, and common treatments.

A heart block, also known as an atrioventricular (AV) block, is classified by degree, based on the severity of the electrical blockage between the upper and lower heart chambers.

First degree

In first-degree heart block, electrical signals slow down as they move from the upper to lower chambers of the heart. However, the signals do not stop, even intermittently.

First-degree heart block is more common in adults over 60, affecting about 6% of this population. The prevalence of first-degree heart block in people younger than 60 years is 1% to 1.5%.

High school

Second-degree heart block is classified in two ways: Type I and Type II.

  • Type I: this is also called Mobitz Type I or Wenckebach AV block. It is a less severe form of second-degree heart block and is characterized by gradually slower electrical activity to the point where the heart skips a beat.
  • Type II: also known as Mobitz Type II, occurs when an increasing number of electrical signals do not reach the ventricles. This causes a slower, abnormal rhythm. Type II is most often associated with structural heart diseasesuch as myocardial fibrosis, a condition involving thickening of heart muscle tissue triggered by high blood pressure or heart disease.

Third degree

Third-degree heart block is more serious than the other types. This means that the electrical signal from the atria is completely blocked from reaching the ventricles.

As a result, the ventricles often start to beat on their own. The heartbeat is much slower and more irregular, making it difficult for the heart to pump enough blood to meet the body’s demands. This can result in a very slow pulse or no pulse at all.

Third-degree heart block is rare, affecting less than 0.05% of the population.

Heart block is usually the result of trauma that affects the heart’s electrical system. Your risk of heart block also increases as you age. Other risk factors include a history of:

Several medical conditions can also increase your risk of heart block, including:

ONE 2019 study also suggests that two major cardiovascular risk factors – high blood pressure and high blood glucose levels – are associated with increased risks of developing heart block.

Open-heart surgery can also increase your risk of heart block or other heart rhythm disturbances (arrhythmias).

Also, heart block can be a side effect of some types of medications. Medications associated with heart block include:

Though rare, heart block can also be a congenital condition, affecting around 1 in 15,000 to 22,000 live births. In most cases of congenital heart block, the mother had an autoimmune disorder such as lupus or Sjögren’s syndrome.

The type and severity of symptoms depend on the type of heart block.

first degree symptoms

Often, first-degree heart block has no symptoms. An abnormal heart rate and rhythm can be detected during a routine electrocardiogram (ECG).

second degree symptoms

When symptoms are present in second-degree heart block, they usually include fatigue and dizziness, sometimes resulting in fainting (syncope). Other possible second-degree heart block symptoms include:

  • chest pain
  • heart palpitations (feeling that the heart is stopping)
  • nausea
  • shallow or rapid breathing

third degree symptoms

Symptoms caused by third-degree heart block are usually more severe and are considered a medical emergency. The most common symptoms include:

Heart block is not always serious, but it depends on the type. First-degree and even second-degree (Type I) heart block can be controlled with little or no treatment. These types of heart block may have little impact on your long-term health or quality of life.

Second-degree (Type II) and third-degree heart blocks usually need a pacemaker, but with certain lifestyle changes, you can live comfortably for a long time. In rare cases, patients who have frequent episodes of fainting (syncope) due to heart block may also need a pacemaker.

One of the most serious risks of heart block is heart failure. ONE 2018 study suggests that, in cases of complete heart block, there is a significantly increased risk of heart failure. Third-degree heart block can also cause damage to internal organs and cardiac arrest (no heartbeat).

A comprehensive assessment of your heart health should include a physical exam in which your doctor listens to your heart with a stethoscope. They should also review your personal and family medical history, medications and supplements you’re taking, and your symptoms.

First-degree heart block and some cases of second-degree heart block are usually detected through a routine physical examination and ECG. An ECG is a non-invasive test that uses electrodes to measure the rhythm, rate, and strength of the heart, as well as the pattern of the heart’s electrical activity.

For intermittent electrical abnormalities, you may be advised to wear a portable ECG monitor, such as a Holter monitor, for 24 hours or more.

In rare cases, your doctor may also order an electrophysiological study, which involves placing a catheter into a blood vessel. The catheter is then guided into the heart to monitor the heart’s electrical activity.

Most cases of first-degree heart block do not require any treatment. However, with some types of second-degree heart block, as well as third-degree heart block, a pacemaker is usually needed.

A pacemaker is a small, battery-powered device that is surgically implanted in your chest. It detects when the heart is beating abnormally and sends gentle electrical charges to the heart to restore a healthy heartbeat.

A study of pacemakers to treat heart block suggests that both dual-chamber pacing (which involves sending signals to both the upper and lower heart chambers) and synchronous ventricular pacing (which only paces the lower chamber) are effective long-term solutions. term for heart problems. block. However, having heart failure or other serious medical conditions can affect long-term effectiveness.

Heart block cannot always be prevented. As it is often a complication of heart disease, the best way to reduce your risk is to follow a heart-healthy lifestyle that includes:

  • eating a heart-healthy diet, such as the Mediterranean diet
  • exercising regularly, aiming for at least 150 minutes a week of moderate-intensity aerobic activity
  • Do not smoke
  • managing your weight
  • managing stress in a healthy way, including getting 7 to 9 hours of sleep every night
  • having regular check-ups with your doctor

Heart block is the interruption of the flow of electrical energy from the upper chambers of the heart (atria) to the lower chambers (ventricles). If it’s a minor disruption, you may not need treatment. However, if the heart block is more severe, you may need a pacemaker to maintain healthy heart function.

While heart block is not always preventable – age and heart disease are the most common risk factors – a heart-healthy lifestyle that reduces your risk of heart attack and cardiovascular disease can help lower your chances of developing this condition. .

Heart block: types, causes, symptoms, treatment

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