Prolonged PR Interval: Causes & Reasons

Possible Causes for Prolonged PR Interval

The hallmark of Mobitz type 1 block is the gradual prolongation of PR intervals before a block occurs. Mobitz type 2 block has constant PR intervals before blocks occur. [ecgwaves.com]

interval becomes prolonged. [ecgwaves.com]

Thus, if one can spot the gradual prolongation of PR intervals, Mobitz type 1 block should be diagnosed. [ecgwaves.com]

AV Block Mobitz II

The hallmark of Mobitz type 1 block is the gradual prolongation of PR intervals before a block occurs. Mobitz type 2 block has constant PR intervals before blocks occur. [ecgwaves.com]

However, there is a delay within the AV node, resulting in a prolonged PR interval on ECG (>200 msec or >5 small blocks). [wikidoc.org]

Commonly used terminology includes: ● First degree AV block – Delayed conduction from the atrium to the ventricle (defined as a prolonged PR interval of >200 milliseconds) [uptodate.com]

Second Degree Atrioventricular Block

This case demonstrates the need for caution and interval cardiac testing when adding LCM to other AEDs known to prolong the PR interval. [ncbi.nlm.nih.gov]

The hallmark of Mobitz type 1 block is the gradual prolongation of PR intervals before a block occurs. Mobitz type 2 block has constant PR intervals before blocks occur. [ecgwaves.com]

On the surface ECG this is realized through a prolonged PR interval. [ems12lead.com]

Hyperkalemia

PR interval, wide QRS complex) as an alternative to 10 units of short acting insulin. [ncbi.nlm.nih.gov]

prolonged PR interval, prolonged QRS interval, loss of P wave, sine waves and finally ventricular fibrillation (see ECG guideline for normal values for age) ECG CHANGES [starship.org.nz]

Notes The classic ECG progression in hyperkalemia is: Peaked T waves Prolonged PR interval and flattening of the P wave Widening of the QRS Sine wave However. you cannot rely [first10em.com]

First-Degree Atrioventricular Block

Data is sparse on an extremely prolonged PR interval associated with Atrioventricular Dissociation and Pseudo-Pacemaker Syndrome. [ncbi.nlm.nih.gov]

Context Prolongation of the electrocardiographic PR interval, known as first-degree atrioventricular block when the PR interval exceeds 200 milliseconds, is frequently encountered [dx.doi.org]

Standard 12-lead electrocardiogram showed an uncommon Marked First Degree Atrioventricular Block with an extremely prolonged PR interval of 0.56 s. [ncbi.nlm.nih.gov]

Rheumatic Fever

We report on a 10-year-old boy who presented with progressive right side involuntary movements, an apical systolic murmur, prolonged PR interval, and elevated antistreptolysin [ncbi.nlm.nih.gov]

PR interval on an electrocardiogram Laboratory Criteria for Diagnosis No specific laboratory test exists for the diagnosis of rheumatic fever Case Classification Confirmed [wwwn.cdc.gov]

Minor manifestations include fever, arthralgia and laboratory findings of elevated erythrocyte sedimentation rate, C-reactive protein and prolonged PR interval on ECG. [ncbi.nlm.nih.gov]

Ostium Primum Atrial Septal Defect

Complete heart block may be revealed in ostium primum type Large ASD may have prolonged PR interval 18. [slideshare.net]

Prolongation of the PR interval: first degree atrioventricular block ( less frequent than ostium primum ASD ). [metealpaslan.com]

Individuals with atrial septal defects may have a prolonged PR interval (a first degree heart block). [marmur.com]

Sinoatrial Block

This is different than a first-degree atrioventricular, or AV, block, which shows a prolonged PR interval. [healio.com]

Mobitz Type 1 (Wenckebach) • Gradual prolongation of PR interval until nonconducted p wave • RP-PR reciprocity • Lengthening of the PR interval at progressively shorter decrements [slideshare.net]

In the Mobitz I second-degree AV block, the PR interval is prolonged until the P wave is not followed by a QRS complex. [emedicine.medscape.com]

Hypokalemia

PR interval. [ausmed.com]

ECG features of hypokalaemia (K < 2.7 mmol/L) Increased P wave amplitude Prolongation of PR interval Widespread ST depression and T wave flattening/inversion Prominent U waves [litfl.com]

[…] image depicts an ECG from a person with a potassium level of 1.1 showing the classical ECG changes of ST segment depression, inverted T waves, large U waves, and a slightly prolonged [ausmed.com]

Lyme Carditis

A repeat ECG showed a first-degree AV block with a markedly prolonged PR interval of greater than 400 ms. [journals.lww.com]

The other 2 patients had improved but still had mildly prolonged PR intervals at short-term follow-up. Thus, Dr. [borrelioosifoorumi.net]

Those with a markedly prolonged PR interval (≥300 ms) seem to be at the greatest risk for progression to complete heart block. [journals.lww.com]

Cardiac Glycoside Poisoning

Electrocardiogram revealed inverted P wave in inferior lead and prolonged PR interval (.28 s), with varying degree AV blocks and normal QRS duration [Figure 1] and [Figure [heartviews.org]

Many patients with moderate poisoning show PR interval prolongation and progression to atrioventricular (AV) dissociation. [heart.bmj.com]

Página 153 - Significance of isolated HV interval prolongation in symptomatic patients without documented heart block - Altschuler H., Fisher JD and Furman S. ‎ [books.google.es]

Rheumatic Heart Disease

ECG reveals no diagnostic changes, but 20% of patient show a prolonged PR interval. 15. [slideshare.net]

Only 35% of children with ARF have a prolonged PR interval; higher-degree heart block may occur but is uncommon. [merckmanuals.com]

PR interval[ 8 ] [ 9 ] (Cannot be included if carditis is present as a major symptom) Previous episode of rheumatic fever or inactive heart disease Other signs and symptoms [textbookofcardiology.org]

Diphtheritic Myocarditis

The following ECG changes may be noted in patients with rheumatic fever : [1] Sinus tachycardia or bradycardia depending on vagal tone Prolongation of PR interval Variable [wikidoc.org]

In electrocardiographic tracings, a prolonged PR interval, changes in the ST-T wave, and single or progressive cardiac dysrhythmias can occur, such as first-degree, second-degree [emedicine.medscape.com]

Typical manifestations include cardiac murmurs and transient electrocardiographic abnormalities, such as prolongation of the PR interval and nonspecific ST-segment and T wave [intechopen.com]

Electrolyte Imbalance

Prolonged QT interval D. Shortened ST segment 68. A. Prominent U waves B. Prolonged PR interval C. Depressed ST segment D. Widened QRS complexes 69. A. Alcoholism B. [proprofs.com]

 Assessment findings: serum magnesium level is greater than 2.3mg/dl creatinine clearance decreases to less than 3.0ml/min ECG finding: prolonged PR interval : tall T waves [slideshare.net]

The PR interval is prolonged. Occasionally sinoatrial (SA) block, second- or third-degree atrioventricular (AV) block may develop. [ecgwaves.com]

Accidental Hypothermia

As temperatures continue to drop, the ECG will demonstrate prolonged intervals: PR, followed by QRS and then QTc. [foamcast.org]

An increased PR interval, a widened QRS complex, and a prolonged QT interval signal progressing hypothermia. [nursingcenter.com]

[…] of the PR, QRS, and QT intervals, in that order. 17 There also may be T wave changes that mimic myocardial ischemia. 17 Below 32.2°C (90°F), atrial and ventricular dysrhythmias [ahcmedia.com]

Digitalis Toxicity

The earliest signs of toxicity in the newborn are undue slowing of the pulse rate (bradycardia), sinoatrial arrest and prolongation of the PR Interval (A Collins Abrams, 2006 [rn.com]

ECG Changes The use of therapeutic doses of LANOXIN may cause prolongation of the PR interval and depression of the ST segment on the electrocardiogram. [rxlist.com]

Sick Sinus Syndrome

First-degree heart block, or first-degree atrioventricular (AV) block, is defined as prolongation of the PR interval on the ECG to more than 200 msec. [slideshare.net]

Pronounced PR interval prolongation. The effect of this PR interval prolongation on AV dyssynchrony is demonstrated in this ECG image. [emedicine.medscape.com]

Clinical Findings:        History: Generally asymptomatic at rest Markedly prolonged PR interval may reduce exercise tolerance in some patients. [slideshare.net]

Patent Foramen Ovale

Individuals with atrial septal defects may have a prolonged PR interval (a first degree heart block). [marmur.com]

Individuals with atrial septal defects may have a prolonged PR interval (a first-degree heart block ). [en.wikipedia.org]

The prolongation of the PR interval is probably due to the enlargement of the atria that is common in ASDs and the increased distance due to the defect itself. [marmur.com]

Cardiomyopathy

A less specific finding in sarcoidosis is the presence of conducting system disease with the prolongation of the PR interval and AV block, which almost never occurs in ARVC [hrcak.srce.hr]

interval prolongation, and symptoms refractory to conventional medical treatment. [heart.bmj.com]

[…] depending critically on the native QRS duration and the paced AV delay.19 Patients should be considered for biventricular pacing if they have QRS duration greater than 150 ms, PR [heart.bmj.com]

Restrictive Cardiomyopathy

Note the low voltage in the precordial leads and a prolonged PR interval at 20 ms. [academic.oup.com]

[…] it will have low voltage in the precordial leads with prolonged PR interval ( Figure 6 ). [academic.oup.com]

The differential diagnosis here lies on the ECG, which in hypertrophic cardiomyopathy (HCM) patients will show high voltage with normal PR interval, whereas in amyloid hearts [academic.oup.com]

Lyme Disease

[…] of the PR interval to more than 30 milliseconds (the degree of block may fluctuate and worsen very rapidly in such patients) See Treatment and Medication for more detail. [emedicine.medscape.com]

[…] advisable for patients with any of the following: Associated symptoms (eg, syncope, dyspnea, or chest pain) Second-degree or third-degree AV block First-degree heart block with prolongation [emedicine.medscape.com]

Myotonic Dystrophy

The ECGs typically showed concordant prolongation in the PR interval and QRS duration. [nejm.org]

PR and QT intervals, QRS widening, the development of sinus node dysfunction, second- and third-grade atrioventricular block (AVB), right branch bundle block, and left atrial [revespcardiol.org]

[…] these patients do not report clinical heart failure) 3 and, more frequently, by electrocardiographic changes (in up to 30.2% of patients). 4, 5 Other manifestations include prolonged [revespcardiol.org]

Morbid Obesity

Morbid obesity is associated with liver pathology, most commonly non-alcoholic steatohepatitis (NASH) leading to cirrhosis. However, the morbid obesity impedes qualification for organ transplantation. We present a case report of a 56-year-old woman who underwent bariatric procedure followed by liver transplantation[…] [ncbi.nlm.nih.gov]

Hemochromatosis

Hemochromatosis is the abnormal accumulation of iron in parenchymal organs and the most common form of iron overload disease. It may be inherited or acquired. The patients suffering from hemochromatosis have the following clinical picture. The skin of these patients acquires a bronze pigmentation due to the[…] [symptoma.com]

Corynebacterium Diphtheriae

A prolonged PR interval with changes in the ST-T waves were noted on her electrocardiogram. [ijmm.org]

Patent Ductus Arteriosus

History As discussed in Pathophysiology, the ductus arteriosus is always patent in the fetus if the cardiovascular system is otherwise normal. Normally, the ductus arteriosus closes functionally in the first 10-18 hours of life. Prematurity, perinatal distress, and hypoxia delay closure of the ductus arteriosus;[…] [emedicine.medscape.com]

Third Degree Atrioventricular Block

Patients with conduction abnormalities originating in the His or Purkinje systems are more likely to have prolonged QRS intervals as well as the prolonged PR interval of first-degree [ncbi.nlm.nih.gov]

On the surface ECG this is realized through a prolonged PR interval. [ems12lead.com]

First Degree Atrioventricular Block Caused by: – delay in in atrioventricular conduction •Heart rate unchanged •Treatment not necessary On ECG: –Prolonged PR interval 3. [youtube.com]

Axial Spondyloarthritis

Copy/Paste the key inputs from the product brochure, per guidance from Marketing. The axial spondyloarthritis (AxSpA) market boasts biologics representing two distinct drug classes, the blockbuster tumor necrosis factor-alpha (TNF-α) inhibitors (Amgen’s Enbrel, AbbVie’s Humira, Janssen’s Remicade and Simponi /[…] [decisionresourcesgroup.com]

Ankylosing Spondylitis

Abstract The cauda equina syndrome in ankylosing spondylitis (the CES-AS syndrome) is marked by slow, insidious progression and a high incidence of dural ectasia in the lumbosacral spine. A high index of suspicion for this problem must be maintained when evaluating the patient with ankylosing spondylitis with a[…] [doi.org]

Acute Myocarditis

AIM: Cardiac magnetic resonance (CMR) can visualize inflammatory tissue changes in acute myocarditis. Several quantitative image-derived parameters have been described to enhance the diagnostic value of CMR, but no direct comparison of these techniques is available. METHODS AND RESULTS: A total of 34 patients with[…] [ncbi.nlm.nih.gov]