Assignment: Complete Heart Block
Assignment: Complete Heart Block
A complete heart block is classified as a third-degree atrioventricular (AV) block. AV block occurs when supraventricular impulses are excessively delayed or completely blocked in the AV node or ventricular conduction system. The sinoatrial (SA) node continues to function normally, and atrial depolarizations and P waves occur regularly. Due to conduction dysfunction, ventricular depolarizations and QRS complexes are usually delayed or blocked (Kerola et al., 2019). In a complete heart block, none of the sinus impulses reaches the ventricles. Therefore, the ventricles are depolarized by a second, independent pacemaker.
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Complete heart block presents with varying clinical presentations in patients, but patients are hardly asymptomatic. Common symptoms in third-degree AV block include generalized fatigue, chest pain, dyspnea, presyncope, or syncope. A patient is considered symptomatic if these symptoms are present. Besides, a patient may have a marked hemodynamic instability and a decreased level of alertness or consciousness (Bhasin & Roy, 2019). However, a patient’s health status during presentation varies based on the coexisting health conditions and the rate of the escape rhythm. The patient assessment also entails taking vital signs and monitoring the patient on an ECG. Continuous monitoring of the patient’s ECG rhythm is essential to assess for manifestations of dysrhythmias, like abnormal pulse rate and rhythm, decreased blood pressure, and dyspnea (Bhasin & Roy, 2019). The presence of atrioventricular dissociation on ECG is diagnostic of complete heart block.
Treatment for third-degree AV block includes dopamine and epinephrine to improve bradycardia. However, they are sometimes unsuccessful in improving the heart rate. Patients often require temporary pacing, for example, transcutaneous pacing, which is more rapid (Kerola et al., 2019). Temporary pacing is a non-surgical intervention that produces a timed electrical stimulus to the heart when the initiation of impulse or the heart’s conduction system is defective.
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References
Bhasin, D., & Roy, A. (2019). Complete Heart Block. Circulation, 140(6), 516–519. doi:10.1161/circulationaha.119.042001
Kerola, T., Eranti, A., Aro, A. L., Haukilahti, M. A., Holkeri, A., Junttila, M. J., … & Marcus, G. M. (2019). Risk factors associated with atrioventricular block. JAMA network open, 2(5), e194176-e194176. doi:10.1001/jamanetworkopen.2019.4176
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