Dawaa Reference

chronic

Atrioventricular block

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

Atrioventricular Block - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK459147/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class KD70.00 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care

Verified against1 document
  • No dose - referral pathway, no medicine given in primary care

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (3)

  • First-degree and Mobitz type I second-degree block are usually silent, found incidentally on exam or ECG
  • Breathlessness on exertion, easy tiring, dizziness and fainting are the typical symptoms [breathlessness · dizziness · syncope]
  • Cardiac arrest or sudden death from AV block is rare [heart block · sudden cardiac arrest]

Signs — what you find (1)

  • Slow heart rate, irregular pulse, low blood pressure, and prominent A waves in the neck veins [bradycardia · hypotension · irregular pulse]

Tests (10)

  • First-degree block: every P wave is followed by a QRS, but the PR interval runs longer than 200 ms
  • A PR interval beyond 300 ms is called a marked first-degree block
  • Mobitz type I shows progressive PR lengthening before a dropped beat, at a P-wave rate under 100 bpm
  • Mobitz type II drops beats unpredictably while the PR interval stays constant
  • High-grade block means two or more consecutive P waves fail to conduct despite ongoing AV association
  • Complete (third-degree) block shows total dissociation between P waves and QRS complexes
  • A resting 12-lead ECG is essential to grade the block and locate the site of conduction failure
  • Ambulatory ECG monitoring correlates symptoms with the block better than a single ECG, especially for paroxysmal cases
  • Echocardiogram is recommended in every patient to rule out underlying structural heart disease
  • Selected labs, thyroid function, electrolytes, renal profile and digoxin level, are checked when clinically indicated

If not this — what else fits (2)

  • Isorhythmic AV dissociation can look similar to AV block on the ECG
  • A junctional escape rhythm is another mimicker to rule out

SourceStatPearls "Atrioventricular Block" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)

1st line
Adult dose and duration

Ranges from an incidental ECG finding to a cause of dangerous bradycardia. GP identifies it on ECG and refers to cardiology for evaluation and possible pacemaker; atropine is for emergency symptomatic bradycardia only. - Refer, with advice

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

Ranges from an incidental ECG finding to a cause of dangerous bradycardia. GP identifies it on ECG and refers to cardiology for evaluation and possible pacemaker; atropine is for emergency symptomatic bradycardia only.

Cautions
  • Syncope or presyncope, severe bradycardia, complete heart block, Stokes-Adams attacks.
  • No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.