How common is second-degree heart block in young adults?

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I understand your concern. I want to explain that when we are in front of a cardiac conduction abnormality in a young adult first, it is necessary to exclude an infectious and inflammatory disease, like Lyme disease, sarcoidosis, and other cardiac issues, like myocarditis, and anomalous coronary artery, etc. It is necessary to undergo a full blood test panel and a cardiac ultrasound test. For a more detailed cardiac tissue characterization, it is necessary to undergo a cardiac magnetic resonance imaging test (CMR). Meanwhile, I recommend that your friend refrains from competitive sports and any excessive physical exertion. I hope it is helpful for you.

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First, I would explain that it is not necessary to avoid his job. To be careful and not participate in strenuous physical activities until the real cause of his heart block is clarified. In an aged individual, a heart block raises suspicions about degenerative fibrotic lesions of the cardiac conductance system. But, when in front of a young adult an inflammation or infection issues should be first suspected. Meanwhile, you are waiting for the doctor appointment, you may check cardiac enzymes CK-MB (creatine kinase-muscle/brain), and troponin, if elevated would indicate a cardiac muscle injury. You may also check inflammatory markers like PCR (polymerase chain reaction), and ESR (erythrocyte sedimentation rate), etc. For Lyme disease, it is necessary to perform a serologic test for borreliosis (but should be guided by his doctor). Regarding myocarditis, the discussion is a little difficult, because several specific tests need to be performed like cardiac ultrasound, cardiac MRI and sometimes even cardiac biopsy. If your boyfriend has experienced recently any episode of fever, or signs of acute infection (respiratory, etc.) the suspicion about a myocardial inflammation is high. Now returning to the safety issue, I would recommend performing the cardiac enzymes. If the chest pain persists and if the result are elevated have medical assistance as soon as possible and not to wait a month for doctor appointment. This is my opinion.

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Cardiac enzymes are components of cardiac cells. When myocardial cells are damaged the enzymes get out and show an increased percentage in the circulating blood. The doctor may check CK-MB and troponin. I hope you have information now to understand the importance of this clinical condition.

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He may use CoQ10 (Coenzyme Q10) supplement which is an active substance. As a history of recent respiratory infection is present, I recommend him to proceed with the above-mentioned lab tests. In addition, pain relief medication like Ibuprofen or Naproxen may be used.

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First, before concluding on low blood pressure values, it is necessary to closely monitor BP values for a couple of days up to a week. Also, it is important to avoid dehydration by taking plenty of fluids. An overall cardiac function should be reviewed. A cardiac ultrasound would help in this regard. It is difficult clinically to differentiate different causes of inflammatory heart disease. The blood test mentioned earlier would help. It does not seem to be ischemic heart disease. Nevertheless, if the symptoms give him important limitations during his daily activity, it is necessary to ask medical assistance before an appointment.