AV block

fIRRT DEGREE BLOCK
A>asso wth electrolyte disturbance,use of digitalis,B blocker,ca chanel blocker,acute MI B>asymptomatic C>in ECG,P-R interval is prolong to >than 0.20 sec.All P wave r conducted n QRS is normal D>Rx-correction of eletrolytes imbalance n removal of offending agent
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SECOND DEGRRE BLOCK
A>subdivided into mobitz type 1 n 2
B>mobtiz type 1
1>ocur in acute inferior wall MI n use of digitalis,B blocker,
2>block is transient n pt ir asymptomatic
3>characterised by progresive slowing of AV conduction.ECG -progresive prolongation of P-R interval until P wave is not conducted QRS ir normal
C>moatiz type 2
1>ocur after ANT wall MI
2>pt r symptomatic
3>consant PR interval wth intermitent failure of atrial impulses 2 conduct 2 the ventricle
4>ocur due 2 delay in bundle of his n purkinge system.QRS is abnormal
5>pt require pacemaker
THIRD DEGREE BLOCK
1>in complete heart block,none of atrial impulses reach ventricle
causes of complete heart block-a>congenital
b>acquired-1>digitalis intoxication 2>inf endocarditis 3>lenegre disease 4>MI
C/F-1>regular n slow volume pulse 2>high volume pulse 3>irregular cannon waves on jvp 4>systolic murmur 5>stokes adams attack
Management-1>does not require Rx 2>CHB wth acute ant MI treated by imediate insertion of temporary pacemaker