block terminology- question for Frank

You've mentioned you don't like the general term heart block. Can you tell me the different types of blocks? I know my signals from SA to AV nodes are blocked and my medical records say CCHB but I've had doctors call it BBB, 3rd degree block and av block over the years. Can you please tell me the difference between the terms? I just ignored the different names but you've got me curious :o)

1 Comments

Terminology

by maryanne - 2008-09-01 08:09:34

Well I am not Frank......but here it goes....

Many terms used in the medical field are interchangeable....It's like in the old days we use to call certain IV fluids one thing and now we call them another thing and yes they are still the same fluid just the name has changed.....and this happens frequently in medicine. It also depends on where doctors and nurses where trained and the terminology which was used in their training.

As for heart blocks......there are 1 degree blocks which is caused by extended PR interval(ie the time it takes the pulse to generated from the SA node to the AV node....which ultimately gives you a decreased heart rate or bradycardia.....then you have your 2nd degree blocks....2nd degree block is an arrhythmia in which one or more of the P waves(P waves represent the beginning of the cardiac cycle which you see on an ECG) are not conducted to the ventricles. To make things even more confusing there are three types of 2nd degree blocks.

The first one is a 2nd degree Type 1 also known as Wenckebach(again a term used years ago but now just known at 2nd degree type 1, but they both mean the same thing)This is an arrhythmia in which there is a progessive porlongation of the conduction of the electrical impulses through the AV node occurs until conduction of the electrical impluses through the AV node is completely blocked.

2nd degree Type ll: This type of block occurs when there is complete block of the electrical impluses which occurs in one bundle branch and an intermittent block in the other causing a AV conduction ratio of 4:3 or 3:2 this is very easily visiable on an ECG.

2nd degree 2:1 and high-degree block: This is a type of arrhythmia caused by defective conduction of the electrical impulese through the AV node or the bundle branches or both. Again, you can see significant changes in the ECG.

Then you have your 3 degree block or what is also called Complete heart block. It is the complete absence of electrical conduction from the atria to the ventricles. This may be transient and reversible or permanent(chronic) hence requiring a PM.

As far as blocks go....a person can start out in a 1st degree block and progress to a 3rd block. BBB is Bundle Branch Block. Again this is a block which is happening at a certain part of the electrical contraction....you can have left sided or right sided bundle branch blocks in conjunction with 1st or 2nd degree blocks.

I hope this information helps. If I can be of any further assistance don't be afraid to ask....

Cheers

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