Heart Block: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Heart Block?
A cardiologist, a heart doctor, usually treats heart block. Your primary care doctor may do the first check. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is heart block?
Heart block is a problem in the electrical signals in the heart. Normally, the signal travels from the top chambers of the heart to the lower chambers. This keeps the heartbeat steady and regular.
In heart block, the signal is slowed down or does not reach the bottom chambers. The heart may beat slowly, or it may skip beats. Heart block is also called a conduction disorder.
There are three degrees of heart block. First-degree is the mildest and third-degree is the most severe.
Symptoms
First-degree heart block rarely causes symptoms or problems. You may not know you have it until an electrocardiogram (ECG), a test of the heart's electrical signals, shows it.
With second-degree or third-degree heart block, symptoms may include:
- Chest pain.
- Dizziness.
- Feeling faint or fainting.
- Tiredness.
- Heart palpitations, which feel like your heart is pounding, beating unevenly, or racing.
In third-degree block, the heart may fail to pump enough blood to the body. This can lead to fainting and shortness of breath.
Causes and who gets it
Heart block may be a side effect of medicines such as digitalis, beta blockers, and calcium channel blockers. A heart attack that damages the heart's electrical system can also cause it.
Other causes include heart valve disease and cardiomyopathy, a disease of the heart muscle. Heart surgery can also cause it. Some infections, such as Lyme disease, can cause it too.
Some people are born with heart block. The risk is higher if you have a heart defect or your mother has an autoimmune disease such as lupus.
Conduction disorders can happen at any age. Some healthy young people have first-degree block, especially at rest or during sleep.
How doctors diagnose it
Your provider may suggest you see a cardiologist, a heart doctor. The cardiologist will ask about your medical history and the medicines you take.
They will do a physical exam and check for signs of heart failure, such as swollen ankles and feet. They will do an ECG to check the electrical signals in your heart. You may also need to wear a heart monitor for 24 to 48 hours or longer.
Treatment
Treatment depends on the type of heart block and its cause. With a milder type and no serious symptoms, you may only need regular checkups, medicine changes, and learning how to check your pulse.
If you have second- or third-degree heart block, you may need a pacemaker. A pacemaker is a small device put inside the skin on your chest. It gives off electrical signals to keep your heartbeat regular.
A temporary pacemaker may be used if the heart block is expected to go away in a day or so, or in an emergency before a permanent one is placed.
Heart block caused by a heart attack or heart surgery may go away as you recover. If a medicine is the cause, changing medicines can fix the problem. Do not stop or change how you take any medicine unless your provider tells you to.
If you have a pacemaker, tell the MRI technician before any MRI. Tell airport security staff and ask for another type of screening.
When to see a doctor
Contact your provider if you feel dizzy or weak, or if you have a racing or skipped heartbeat. Also call if you have swollen legs, ankles, or feet. These can be signs of heart failure.
Third-degree heart block is an emergency that needs medical help right away. Call 911 right away if you have chest pain or discomfort that lasts two minutes or more, trouble breathing or shortness of breath, or if you faint or lose consciousness. Call 911 right away too if someone has symptoms of a stroke or sudden cardiac arrest, when the heart stops beating.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care doctor can review your symptoms and medicines and order an ECG or arrange one. They can also refer you to a cardiologist and help with follow-up care.
Common questions
Is heart block serious?
It depends on the degree. First-degree heart block is the mildest and rarely causes problems. Third-degree heart block is the most severe and is an emergency that needs help right away.
Can heart block go away on its own?
Yes, sometimes. Heart block may resolve on its own, or it may be permanent and require treatment.
Do I always need a pacemaker for heart block?
No. With a milder type and no serious symptoms, you may only need checkups and medicine changes. A pacemaker may be needed for second- or third-degree heart block.
Can I stay active with heart block?
Yes, in most cases. With regular monitoring and treatment, you should be able to keep up with most of your usual activities.
Sources
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
