Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with [asymptomatic/palpitations/dizziness/syncope]. ECG reveals progressive PR interval prolongation followed by a non-conducted P wave (Wenckebach phenomenon), consistent with Second Degree AVB Mobitz I. No history of recent MI, electrolyte imbalance, or offending AV-nodal blocking agents.
Clinical Examination Findings
Cardiovascular exam reveals irregular pulse rhythm with periodic dropped beats. Auscultation demonstrates variable S1 intensity. Patient is hemodynamically stable with no signs of overt heart failure or hypoperfusion. Peripheral pulses are palpable but irregular in cadence.
Treatment Protocol
Management plan: 1. Discontinue or reduce dosage of AV-nodal blocking agents (Beta-blockers, CCBs, Digoxin). 2. Correct underlying electrolyte disturbances (K+, Mg2+). 3. Serial ECG monitoring to assess progression. 4. Consider cardiology consultation for electrophysiology study if symptomatic or if progression to higher-degree block is suspected.