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What Does The Following EKG Result Indicate?

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Posted on Mon, 21 Nov 2016
Question: I had a 24 hour EKG and it revealed 2 pauses of 2nd degree AV block type 1 lasting 2.02 seconds. All else was normal, should I be worried?
doctor
Answered by Dr. Benard Shehu (15 minutes later)
No it's not normal and you should contact your cardiologist.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Benard Shehu (21 minutes later)
I have contacted my GP and they are not worried. I had an stress echo, which was normal and a 24 hour BP, again normal. What I would like to know is am I at any risk, what should I and should not do until I see my cardiologist on Monday. And, what is the potential treatments?
doctor
Answered by Dr. Benard Shehu (19 minutes later)
Brief Answer:
Following advice

Detailed Answer:
Hi back,

Based on the data you provided the only abnormalities present are a second degree block grade I accompanied by cardiac pauses of 2.02 seconds. These findings may precipitate to more severe cardiac blocks and fainting.

However since the pauses are less than 2.4 seconds and you have all other exams normal, you are at low risk for cardiac events (including complete cardiac block and fainting).

Before giving you my suggestions I would like to know, what medications you are taking?

Wish you all the best!
Dr. Shehu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Benard Shehu (10 minutes later)
Currently taking: Paracetamol 1 gram every 4 hours from a recent infection. Doxycycline 200mg per day. 5mg diazepam per day. GP also gave me bisoprolol furmarate 2.5mg, but ive not taken it yet .
doctor
Answered by Dr. Benard Shehu (25 minutes later)
Brief Answer:
Following advice

Detailed Answer:
Hi back,

After reviewing your medicine I would like to say that you shouldn't take Bisoprolol at all.

Paracetamol 6 g per day is relatively a large dose and it combined with infection may aggravate the heart block. This is why I strongly recommend that you should educe the dose of paracetamol to 3 g per day (500mg every 4 hours).

Moreover I would suggest that in case of weakness or presyncope you should go directly to ER.

Hope this will be of help!
Wish you health!
Dr. Shehu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Benard Shehu (5 minutes later)
apologies, I got the prescription wrong, I've been taking 1 gram every 6 hours. I did do some research (my job is health scientist) and seen that the Bisoprolol is not the best option and can be a cause of an AV block. I will take the advice and go to 500mg every 4 hours as my ALT went to 107. With this updated and correct information, what do you suggest I don't do before I see the cardiologist. And, what are the treatments for symptomatic patients with second degree AV block type 1?

Thank you
doctor
Answered by Dr. Benard Shehu (19 minutes later)
Brief Answer:
Following advice

Detailed Answer:
Hi back,

Bisoprolol is a betablocker and as a such it may be the cause or the aggravating factor of heart blocks. This is why it's contraindicated n patients with second degree heart block.

You should follow my suggestions about stopping Bisoprolol and reducing Paracetamol. Moreover in case of weaknes (or presyncope) you should drink plenty of drinks especially coffe tea or energy drink (which help to stimulate cardiac activity and HR) and go immediately to ER.

Hope this will be of help!
Wish you health!
Dr. Shehu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Benard Shehu (5 minutes later)
I will follow that advice, I have not currently took the beta blockers and I will reduce paracetamol dose. However, one question I would like asking, just for reference; what is the treatments for symptomatic second degree AV block type 1?
doctor
Answered by Dr. Benard Shehu (8 minutes later)
Brief Answer:
Following advice

Detailed Answer:
Hi back!

The treatment for symptomatic patients (weakness, dizziness presyncope or fainting) with second degree type 1 heart block as i said above is done at ER.

The treatment in symptomatic patients include atropine use and transcutaneous cardiac paicing (pacemaker). As you can see this treatment can't be done at home and need hospitalisation.

Wish you health!
Dr. Shehu
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Benard Shehu

Cardiologist

Practicing since :2004

Answered : 2257 Questions

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What Does The Following EKG Result Indicate?

No it's not normal and you should contact your cardiologist.