Second-Degree AV Block: What You Need to Know

Abnormal electrocardiogram (ECG) findings during a physical examination?

Hello Doctor, I went to the hospital for a military school physical examination three days ago.
Yesterday, I received a call from the hospital stating that my electrocardiogram showed abnormalities, and the doctor diagnosed me with second-degree atrioventricular block, Mobitz type II.
I would like to know if it is possible for this to improve before March 10th.
What should I do now? Should I schedule an appointment with a cardiologist or a cardiac surgeon? I am currently 17 years old, 169.5 cm tall, and weigh 72 kg.
I usually run about 200 kilometers a month and received my first dose of the BNT vaccine on September 29th.
Thank you, Doctor.

Zhong Tongxue, 10~19 year old female. Ask Date: 2021/11/27

Dr. Li Shengkai reply Cardiology

I did not see the electrocardiogram from your physical examination and can only respond based on the text report you provided.
According to the current military service physical examination standards, "second-degree atrioventricular block" is classified as a disqualifying condition for military service.
This condition is more commonly seen in older patients with degenerative heart rhythm issues and is less common in younger individuals.
If your electrocardiogram indeed shows Mobitz type II second-degree atrioventricular block, I recommend that you seek medical attention at a cardiology outpatient clinic as soon as possible.
This condition does not improve on its own and requires medical intervention.
Currently, there is no evidence to suggest that your electrocardiogram abnormalities are related to the BNT vaccine.
In terms of timing, "your electrocardiogram abnormalities were discovered after the vaccine injection," but they may have been present asymptomatically for some time, which is why you may not have noticed them.
Exercise is beneficial, and I suggest that you continue your exercise routine after confirming with a cardiologist that there are no significant issues.
While you may not be able to serve in the military, there are other paths to lead a fulfilling life.

Reply Date: 2021/11/27

More Info

Second-degree AV block, specifically Mobitz type I (also known as Wenckebach), is a condition characterized by a progressive lengthening of the PR interval on an electrocardiogram (ECG) until a beat is dropped. This type of heart block is often seen in younger individuals and can be benign, particularly if there are no accompanying symptoms or underlying heart disease. However, it can also indicate potential issues with the heart's electrical conduction system.

In your case, being 17 years old and active in running, it is less common to see Mobitz type I, but it is not impossible. This condition can occur in athletes due to increased vagal tone, which can affect heart rate and conduction. In many cases, Mobitz type I does not require treatment and may resolve on its own, especially if it is asymptomatic. However, it is crucial to monitor the situation closely.

Regarding your question about whether it could improve by March 10, it is difficult to predict the exact timeline for resolution. Many factors can influence this, including your overall health, any underlying conditions, and how your heart responds to stress and activity. Regular follow-ups with a healthcare provider are essential to monitor your condition.

As for your next steps, it would be advisable to schedule an appointment with a cardiologist, specifically in the field of cardiology rather than cardiac surgery. A cardiologist will be able to assess your ECG findings in the context of your overall health, conduct further tests if necessary, and provide guidance on whether any treatment or lifestyle modifications are needed.

In addition to consulting with a cardiologist, you should also be aware of any symptoms that may arise, such as dizziness, fainting, or palpitations. If you experience any of these symptoms, it is essential to seek medical attention promptly.

In summary, while Mobitz type I can be benign, it is crucial to have a thorough evaluation by a cardiologist to rule out any underlying issues and to ensure that you are monitored appropriately. Given your age and active lifestyle, there is a good chance that this condition may not pose significant risks, but professional medical advice is always the best course of action.

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