First-degree heart block in children is typically which of the following?

First-degree heart block in children is typically which of the following?

• A. Typically asymptomatic and does not require special treatment
• B. Causes syncope
• C. Requires a pacemaker
• D. Is associated with chest pain

Answer: (A)

First-degree heart block means a prolonged PR interval but with every atrial impulse still reaching the ventricles, so there’s no missed beat and cardiac output isn’t typically compromised. In children, this is most often a benign variant, seen in healthy kids or athletes and related to normal variation or higher vagal tone. Because conduction is 1:1 and symptoms are usually absent, no special treatment is needed—just routine observation and follow-up if there’s known structural heart disease or if symptoms develop. If syncope, chest pain, or progression to a higher-degree block occurred, that would change the management and could raise concern for another issue or require pacing. Chest pain isn’t a typical feature of isolated first-degree block, and a pacemaker isn’t indicated for this isolated finding.

First-degree heart block means a prolonged PR interval but with every atrial impulse still reaching the ventricles, so there’s no missed beat and cardiac output isn’t typically compromised. In children, this is most often a benign variant, seen in healthy kids or athletes and related to normal variation or higher vagal tone. Because conduction is 1:1 and symptoms are usually absent, no special treatment is needed—just routine observation and follow-up if there’s known structural heart disease or if symptoms develop. If syncope, chest pain, or progression to a higher-degree block occurred, that would change the management and could raise concern for another issue or require pacing. Chest pain isn’t a typical feature of isolated first-degree block, and a pacemaker isn’t indicated for this isolated finding.