Bifascicular Block RBBB & LPFB

Discussion in 'Health and medical' started by Jeff, Feb 19, 2004.

  1. Jeff

    Jeff Guest

    I'm 30 years old in otherwise perfect health with low cholesterol
    (160) and low blood pressure. After complaining about mild chest pains to my doctor, she
    recommended an EKG. Other than mild chest discomfort, I had no other symptoms. My EKG test
    results show RBBB
    (w/right axis deviation) & LPFB, possible left altrial enlargement (QRSD=131), and a probable early
    repolarization pattern. A week later I saw cardiologist and he said that he'll run additional
    tests but he wasn't worried. My cardiologist also insisted that the original EKG was accurate and
    there was no need to run a second one. I'm scheduled to do a stress test in a few weeks.

    I have several questions that I received conflicting answers on;
    1. Isn't LPFB very rare? Can it be accurately detected by EKG/ECG?
    2. What are the implications of the RBBB & LPFB diagnosis? (i.e. long term effects, risk)
    3. Is it true that altrial enlargement can be found in physically fit athletes?
    4. For the last three years, I've been running and cycling extensively each week, burning around
    5,000 calories a week w/an average exercise heart rate around 160bpm. Could these activities have
    contributed to my condition? Is it safe to continue these activities?
    5. Is chest pain a symptom of my condition(s)? My doctor says no by my cardiologist says it's
    possible. If not, am I likely asymptomatic?
    6. I've read that right axis deviation could be an indicator or Wolff-Parkinson-White Syndrome
    (WFW). Is this correct?
    7. How serious is this? My doctor says they'll probably just need to watch the condition.
    I'm waiting for a final synopsis from my cardiologist but nobody seems too concerned
    (except my wife).
    8. Am I at a higher risk of Sudden Cardiac Death (SCD)?

    I'd appreciate any interpretations and/or opinions. Thank you in advance!
     
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  2. Jeff wrote:
    >
    > I'm 30 years old in otherwise perfect health with low cholesterol
    > (160) and low blood pressure. After complaining about mild chest pains to my doctor, she
    > recommended an EKG. Other than mild chest discomfort, I had no other symptoms. My EKG test
    > results show RBBB
    > (w/right axis deviation) & LPFB, possible left altrial enlargement (QRSD=131), and a probable
    > early repolarization pattern. A week later I saw cardiologist and he said that he'll run
    > additional tests but he wasn't worried. My cardiologist also insisted that the original EKG was
    > accurate and there was no need to run a second one. I'm scheduled to do a stress test in a few
    > weeks.
    >
    > I have several questions that I received conflicting answers on;
    > 1. Isn't LPFB very rare?

    It is uncommon.

    > Can it be accurately detected by EKG/ECG?

    Yes.

    > 2. What are the implications of the RBBB & LPFB diagnosis? (i.e. long term effects, risk)

    Depends on the cause.

    > 3. Is it true that altrial enlargement can be found in physically fit athletes?

    Yes, atrial enlargement can be found in athletes, but it is not commonly associated with
    athleticism.

    > 4. For the last three years, I've been running and cycling extensively each week, burning around
    > 5,000 calories a week w/an average exercise heart rate around 160bpm. Could these activities
    > have contributed to my condition?

    Possibly.

    > Is it safe to continue these activities?

    That remains to be determined by your cardiologist.

    > 5. Is chest pain a symptom of my condition(s)?

    Bundle branch block conduction abnormalities are typically without symptoms.

    > My doctor says no by my cardiologist says it's possible.

    I believe your cardiologist was trying to explain that myocardial ischemia which can cause chest
    pain can also cause bundle branch conduction abnormalities.

    > If not, am I likely asymptomatic?

    You are by definition, symptomatic.

    > 6. I've read that right axis deviation could be an indicator or Wolff-Parkinson-White Syndrome
    > (WFW). Is this correct?

    Yes.

    > 7. How serious is this? My doctor says they'll probably just need to watch the condition. I'm
    > waiting for a final synopsis from my cardiologist but nobody seems too concerned (except my
    > wife).

    Would suggest you wait for the synopsis from your cardiologist.

    > 8. Am I at a higher risk of Sudden Cardiac Death (SCD)?

    Depends on your heart function.

    > I'd appreciate any interpretations and/or opinions. Thank you in advance!

    You are welcome :)

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    Andrew

    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    http://www.heartmdphd.com/

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