Heart block

This is where the electrical impulses passing from the atriums to the ventricles is disrupted or blocked. This causes the heart to pump less efficiently.

With heart block, the conduction of impulses is delayed (first-degree heart block) or not all the impulses from the atrium are conducted (second-degree heart block). In third-degree or complete heart block, no impulses are conducted and the ventricles beat at their own rate of about 20 to 40 beats a minute.

Some people are born with problems with the electrical activity of the heart. Heart block is often seen after a heart attack and in people with heart disease or disease of the heart valves. It is most commonly seen in the elderly as a result of ageing.

Symptoms can come on gradually or suddenly and usually include:

• Palpitations (being aware of an irregular heartbeat)
• Being breathless
• Chest pain; and
• Feeling light-headed, and fainting if the heart stops beating.

Sometimes there are no symptoms.

The damage that causes complete heart block may be associated with coronary heart disease. Factors such as smoking, high cholesterol and high blood pressure increase the risk of coronary heart disease. Sudden complete heart block, which may be either temporary or permanent, may follow a heart attack.

Your doctor may suspect heart block if you have the symptoms described above and a slow heart rate. It is confirmed by an ECG (electrocardiogram).

The treatment for first- and second-degree heart block is as follows.

• Reviewing the medication you are currently taking as some medication can cause the heart to beat slower and cause these types of heart block.
• In some cases a temporary or permanent pacemaker may be needed.

The treatment for third-degree (complete) heart block is having a permanent pacemaker fitted.