One had a right bundle branch
block and known valvular disease.
Caption: Figure 1: EKG showing borderline AV conduction delay and right bundle branch
block (RBBB) pattern.
In our case, right bundle branch
block was found via ECG.
The incomplete right bundle branch
block, a common finding in athletes, was determined by the consulting cardiologist to be an incidental finding.
Electrocardiogram was consistent with right bundle branch
block with QRS duration 124 ms.
DIAGNOSIS: Sinus rhythm; high-grade second-degree atrioventricular block with a junctional escape rhythm and three capture complexes, each with right bundle branch
block aberration; possible septal myocardial infarct of indeterminate age; ST-T and U wave changes suggesting hypokalemia.
An electrocardiogram revealed sinus rhythm, right bundle branch
block and frequent, premature ventricular beats (Fig 1).The echocardiogram showed right ventricular dilatation and hypocontractile areas.
(5-9) Several studies reported changes in the activity of heart including P-wave axis and amplitude, rightward displacement of QRS and T-axis, reduction of amplitude of QRS complex in limb and precordial leads, sinus tachycardia, Right bundle branch
block (RBBB) etc., among COPD patients.
The QRS complexes are 0.12 seconds in duration and have the pattern of right bundle branch
block (late broad R wave in lead V1) and left anterior fascicular block (QRS axis of -75 degrees with a qR pattern in leads I and a VL and an rS pattern in leads II, III, and aVF).
The ECG on admission showed right bundle branch
block (RBBB) pacemaker rhythm with a rate of 68 beats/min.
DIAGNOSIS: Sinus rhythm, atrial bigeminy with right bundle branch
block (RBBB) type aberrant ventricular conduction of alternate atrial premature complexes (APCs), and Q waves of inferior and anterolateral myocardial infarcts of indeterminate age.
Key words: Acute anterior myocardial infarction, coronary angiography, right bundle branch