3rd degree heart block

We discussed a case about an older man with smoking history, who presented with acute exertional dizziness + fatigue + diaphoresis + nausea + presyncope, found to have symptomatic bradycardia due to 3rd degree heart block.

SYNCOPE FRAMEWORK

ACLS ADULT BRADYCARDIA ALGORITHM

  • In 2020, there was an update that recommended the 1st dose of Atropine given be 1mg (instead of 0.5mg) q3-5 min for a max of 3 mg.

PERMANENT PACEMAKER PLACEMENT INDICATIONS
FIRST, RULE OUT ALL REVERSIBLE CAUSES!

  1. Symptomatic bradycardia due to sinus node dysfunction
  2. Permanent afib & symptomatic bradycardia
  3. Alternating bundle branch blocks
  4. Asymptomatic high-degree AV block, 2nd degree Mobitz type 2 block, or 3rd degree block

REFERENCES

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