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The main causes of atrioventricular heart block, diagnosis and treatment


Slowing or complete blockage of electrical impulses between the atrium and the ventricle, known medically as atrioventricular heart block, in most cases occurs in individuals with a history of fixed cardiopathology.

The disease provokes a deterioration of hemodynamics and disruptions of the cardiac rhythm, which in turn can cause disorders in many organs and systems.

Causes of atrioventricular block

To cause partial or complete blockade of the atrioventricular node can diverse phenomena and processes in the body, which can be divided into two groups:

  1. The reasons of a functional nature.
  2. The causes of organic nature - a pathology of the cardiovascular system, surgery and chemical effects on the myocardium and/or directly on the conductive pulse bundles.

The first group includes increasing the tone of the SS division of the nervous system, which interferes with the process of internal regulation of transmission of impulses between tissues of the human body. Such changes often affect not only the heart but also other organs.

Cardiopathologies blockade of the atrioventricular centre is formed in many diseases in which the conductive fibers of the myocardium arise sclerotic or fibrotic lesions.

These include:

  • rheumatic diseases with complications on the heart;
  • myocarditis, connective tissue and autoimmune cardiomyopathy, thyrotoxic and diphtheritic origin;
  • benign and malignant tumors in the myocardium and other tissues (tumors);
  • sclerosis of the cardiac vascular;
  • sarcoidosis;
  • amyloidosis;
  • syphilis.

Partial atrioventricular block, caused by organic damage, over time, can progress to a more complex form of up to complete heart block.

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Pathology leads to deterioration of hemodynamics a total character. In most cases the situation is solved surgery.

Symptoms of AV-blockade

Clinical manifestations of the disease depend on many factors, among which the doctors attributed the cause of its occurrence and the extent of damage to the atrioventricular node, the presence of concomitant cardiopathology and the level of damage (localisation).

Symptomatic manifestations of atrioventricular block at the initial stage of the disease do not exist or are insignificant. The deterioration of the patient are observed only at considerable physical exertion.

The most common symptoms:

  • shortness of breath;
  • weakness or unexplained fatigue;
  • the feeling of squeezing of a thorax.

In rare cases, first degree atrioventricular heart block accompanied by loss of consciousness for a short time and dizziness. Typically, these symptoms occur when incomplete blockade.

The second degree of disease has a variety of symptoms. To periodic weakness and shortness of breath add the following problems:

  • noticeable slowing of the heart rate (fading);
  • weak headaches;
  • the lack of desire to engage in the usual chores due to constant fatigue.

The progression of the disease up to 3 degrees are most often characterized by the appearance of constant shortness of breath and fits of blinking. This syndrome occurs abruptly and unexpectedly, and has the following symptoms:

  • the darkening of the eyes;
  • strong weakness;
  • pain in region of heart;
  • the onset of syncope;
  • cramps;
  • acrocyanosis, rolling in cyanosis (blueness or pallor of nasolabial triangle, ears, etc.).

In the case when the patient comes complete atrioventricular block, the above symptoms become worse and disturb it, even in a state of complete rest.

The treatment of the disease

For patients with 1 degree of disease is the monitoring of their condition in dynamics. Serious treatment need of patients diagnosed with 2 or 3 degree atrioventricular heart block. The list of therapeutic measures depends on what events led to the conduction of the signal.

When an embargo as a result of the medication it is necessary to revise their dosage or even cancel the application. This is enough to restore normal heart rhythm.

In other cases, the patient shows a medical treatment aimed at addressing the main diseases caused by blocking conduction.

If there is concomitant heart pathology, including congenital, the patient shows course admission beta-agonists and atropine. In myocarditis, angina, myocardial infarction and ischemic heart disease - intravenous drip of the drug Izadrin, and after the restoration of heart rhythm oral administration of Alupent. If the patient on the background of this therapy have pain in the projection of the heart, he had shown Prednisone at a dose of 180 mg. the Course of treatment - not less than 10 days.

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When atrioventricular block, accompanied by acute heart failure patients are intravenous Glucagon in a dose of 5 mg, then drip witha dosage of 2-10 mg/h depending on the current state.

If the stagnant form of heart failure in the scheme of therapy include diuretic drugs, and vasodilators.

In the absence of the effectiveness of conservative methods of therapy the patient shows cardiac pacemaker implantation.

The criteria for selection of patients for the conduct of such operations are:

  • the frequency of occurrence and the severity of the symptoms;
  • the absence of obvious symptoms of the blockade on the rapid progression of the disease;
  • atrioventricular block 3 degrees;
  • the presence of other types of blockades.

In the absence of supervision by a cardiologist and appropriate treatment of atrioventricular heart block can lead to cardiac asthma and even sudden cardiac arrest. Particular danger this disease poses to the elderly and individuals leading unhealthy lifestyle.