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RBBB & myocardial infarct

Qingyu Wang, Shuo Pan, Fuqiang Liu, Dan Yang, Jun-Kui Wang
BACKGROUND New-onset extreme right axis deviation and right bundle branch block (RBBB) are rare during acute myocardial infarction (AMI), and has only been reported in several cases reflecting the severity of AMI. It could predict severe clinical complications and higher risks in coronary artery disease. Although there is little electrophysiological explanation, the complications are severe. They should be emphasized in newly diagnosed extreme right axis deviation and RBBB in AMI. CASE REPORT A 72-year-old male was admitted to our department with a chief complaint of intermittent retrosternal chest pain and was diagnosed with extensive anterior myocardial infarction with RBBB, by elevated myocardial enzymes and ECG...
May 11, 2018: American Journal of Case Reports
Juntao Wang, Hongxing Luo, Chunling Kong, Shujuan Dong, Jingchao Li, Haijia Yu, Yingjie Chu
Background: Patients with acute myocardial infarction (AMI) and bundle-branch block have poor prognoses. The new European Society of Cardiology guideline suggests a primary percutaneous coronary intervention strategy when persistent ischemic symptoms occur in patients with persistent ischemic symptoms and right bundle-branch block (RBBB), but the level of evidence is not high. In fact, the presence of RBBB may lead to the misdiagnosis of transmural ischemia and mask the early diagnosis of ST-elevation myocardial infarction...
2018: PeerJ
Jingchao Li, Xiaodong Li, Shujuan Dong, Yapan Yang, Yingjie Chu
The value of the right bundle branch block (RBBB) in the treatment of acute myocardial infarction remains unclear. Studies on the RBBB may significantly influence the treatment of acute myocardial infarction. A total of 845 patients with acute myocardial infarction who underwent primary coronary angiography at Henan Provincial People's Hospital were analyzed. Higher peak enzyme levels, a higher ratio of Killip ≥II and closer proximal occlusion of infarct-related artery (IRA) were observed in patients with RBBB compared with those without...
March 2018: Experimental and Therapeutic Medicine
Rikke Hansen, Martin Frydland, Ole Kristian Møller-Helgestad, Matias Greve Lindholm, Lisette Okkels Jensen, Lene Holmvang, Hanne Berg Ravn, Jesper Kjærgaard, Christian Hassager, Jacob Eifer Møller
BACKGROUND: QRS duration has previously shown association with mortality in patients with acute myocardial infarction treated with thrombolytics, less is known in patients with suspected ST segment elevation myocardial infarction (STEMI) when assessing QRS duration on prehospital ECG. Thus, the objective was to investigate the prognostic effect of QRS duration on prehospital ECG and presence of classic left and right bundle branch block (LBBB/RBBB) for all-cause mortality in patients with suspected STEMI...
December 15, 2017: International Journal of Cardiology
Natalie Held, Nathaniel Little, Mori J Krantz, Brian L Stauffer
BACKGROUND Recognition and appropriate management of right ventricular (RV) infarction is essential, as RV injury increases mortality and substantially alters management during acute coronary syndrome. We report a case of RV infarction presenting with new right bundle branch block (RBBB), and therapeutic use of inhaled epoprostenol to reduce RV afterload and augment cardiac output during refractory cardiogenic shock. CASE REPORT A 53-year-old male presented to our institution in ventricular fibrillation with subsequent development of RBBB in the setting of proximal right coronary artery occlusion...
March 16, 2017: American Journal of Case Reports
John S Pantazopoulos, Alice David, William J Kostis, Nora M Cosgrove, John B Kostis
BACKGROUND: To assess the adverse clinical effects of left anterior hemiblock alone or in combination with right bundle branch block and of complete left bundle branch block in comparison with isolated right bundle branch block and the relationship of these effects with altered mechanoelectric factors resulting in left ventricular dysfunction. METHODS: In a 16-year follow-up study using a statewide database, we studied the occurrence of mortal and morbid cardiovascular (CV) events among patients without apparent ischemic heart disease who had left anterior hemiblock (LAHB, n=4273, right bundle branch block (RBBB) with LAHB (BFBB, n=1857) and left bundle branch block (LBBB, n=9484 compared to isolated RBBB (n=25288)...
May 2017: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
Ali Ahmadi, Koorosh Etemad, Arsalan Khaledifar
OBJECTIVES: Risk factors for heart failure (HF) have not yet been studied in myocardial infarction (MI) patients in Iran. This study was conducted to determine these risk factors. METHODS: In this nationwide, hospital-based, case-control study, the participants were all new MI patients hospitalized from April 2012 to March 2013 in Iran. The data on 1,691 new cases with HF (enrolled by census sampling) were compared with the data of 6,764 patients without HF as controls...
2016: Epidemiology and Health
Li Xiang, Anyuan Zhong, Tao You, Jianchang Chen, Weiting Xu, Minhua Shi
BACKGROUND: The aim of the current meta-analysis was to assess the effect of right bundle branch block (RBBB) on mortality outcome in patients with acute myocardial infarction (AMI). MATERIAL/METHODS: Embase, PubMed, and Cochrane databases were searched through January 2015 using the keywords "RBBB", "mortality", "AMI", "Coronary Heart Disease", and "cardiovascular". An odds ratio (OR) of RBBB on mortality endpoints was calculated using random-effects models. RESULTS: RBBB was associated with significantly increased overall mortality in patients with AMI...
March 27, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Jonah M Pozen, Anit K Mankad, John T Owens, Ion S Jovin
CONTEXT: ST-segment elevations in two or more contiguous leads or new left bundle branch block (LBBB) on electrocardiography (ECG) in a patient with acute onset chest pain are diagnostic criteria for acute myocardial infarction (AMI) and generally warrant urgent coronary angiography and cardiac catheterization. However, the significance of new right bundle branch block (RBBB) without other acute ECG changes is unclear and is currently not considered a criterion. CASE REPORT: We present a patient with chest pain, positive biomarkers of myocardial necrosis and isolated new right bundle block on ECG...
December 2015: North American Journal of Medical Sciences
Jesús Peteiro, Alberto Bouzas-Mosquera, Javier Broullón, Juan Yañez, Dolores Martinez, Jose Manuel Vazquez
OBJECTIVE: Interpretation of the electrocardiogram (ECG) during exercise is not easy in patients with right bundle branch block (RBBB). Also, the value of exercise echocardiography (ExE) for predicting outcome in them has not been addressed. We sought to assess its prognostic value in patients with RBBB and known/suspected coronary disease. DESIGN: Retrospective analysis of data on 703 patients with RBBB who were submitted to a clinically-indicated ExE. The end points were overall mortality and combined myocardial infarction and cardiovascular mortality...
2016: Scandinavian Cardiovascular Journal: SCJ
Yunyun Xiong, Lian Wang, Wenyan Liu, Graeme J Hankey, Biao Xu, Shang Wang
BACKGROUND: The prognostic significance of right bundle branch block (RBBB) is inconsistent across studies. We aimed to assess the association between RBBB (in general population and patients with heart disease) and risk of all-cause mortality, cardiac death, acute myocardial infarction (MI), and heart failure (HF). HYPOTHESIS: RBBB may be associated with increased risk of death. METHODS: PubMed, EMBASE, and the Cochrane Library up to February 2015 were searched for prospective cohort studies that reported RBBB at baseline and all-cause mortality, cardiac death, MI, and HF at follow-up...
October 2015: Clinical Cardiology
Antonio Melgarejo-Moreno, José Galcerá-Tomás, Luciano Consuegra-Sánchez, Nuria Alonso-Fernández, Ángela Díaz-Pastor, Germán Escudero-García, Leticia Jaulent-Huertas, Marta Vicente-Gilabert, Emilio Galcerá-Jornet, Antonio Padilla-Serrano, José de Gea-García, Eduardo Pinar-Bermudez
The aim of this study was to investigate the prognosis associated with bundle branch block (BBB) depending on location, time of appearance, and duration in patients with myocardial infarction (MI). From January 1998 to January 2008, we recruited 5,570 patients with acute MI. Thirty-day and 7-year all-cause mortality, according to BBB location, time of appearance, and duration were analyzed by multivariable analyses. BBB was present in 964 patients (17.3%); right BBB (RBBB) 10.6% and left BBB (LBBB) 6.7%. Overall mortality rate at 30 days was 13...
October 1, 2015: American Journal of Cardiology
Geraldine Gilliot, Pierre Monney, Olivier Muller, Olivier Hugli
Chest pain is a common presenting symptom in emergency departments, and a typical manifestation of acute myocardial infarction (AMI). Recognition of ECG changes in AMI is essential for timely diagnosis and treatment. Right bundle branch block (RBBB) may be an isolated sign of AMI, and was previously considered as a criterion for fibrinolytic therapy. Since the most recent European Society of Cardiology and American Heart Association guidelines in 2013, RBBB alone is no longer considered a diagnostic criterion of AMI, even if it occurs in the context of acute chest pain, as RBBB does not usually interfere with the interpretation of ST-segment alteration...
June 8, 2015: BMJ Case Reports
Sudeep Kumar, Aditya Kapoor, Nagaraja Moorthy, Yash Lokhandwala
Lead induced transient right bundle branch block is not uncommon during pacemaker implantation. We describe a patient with old anterior wall myocardial infarction with severe left ventricular dysfunction presenting with recurrent ventricular tachycardia who developed transient right bundle branch block and pseudomyocardial infacrction pattern during AICD implantation.
January 2015: Indian Pacing and Electrophysiology Journal
Yoshiaki Kaneko, Tadashi Nakajima, Masaki Ota, Masahiko Kurabayashi
No abstract text is available yet for this article.
May 2015: Journal of Cardiovascular Electrophysiology
Pierre-Yves Courand, Adrien Grandjean, Paul Charles, Vinciane Paget, Fouad Khettab, Giampiero Bricca, Loïc Boussel, Pierre Lantelme, Brahim Harbaoui
BACKGROUND: In patients free from overt cardiac disease, R wave in aVL lead (RaVL) is strongly correlated with left ventricular mass index (LVMI) assessed by transthoracic echocardiography. The aim of the present study was to extend this finding to other settings (cardiomyopathy or conduction disorders), by comparing ECG criteria of left ventricular hypertrophy (LVH) to cardiac MRI (CMR). METHODS: In 501 patients, CMR and ECG were performed within a median-period of 5 days...
August 2015: American Journal of Hypertension
Ali Ahmadi, Hamid Soori, Yadollah Mehrabi, Koorosh Etemad, Arsalan Khaledifar
BACKGROUND: Myocardial infarction (MI) care and treatment contribute greatly to the patients' fatality and mortality. Assessing and monitoring mortalities and the effective factors are necessary in MI care and treatment programs. No comprehensive and population-based study has yet been conducted in Iran to determine the epidemiological pattern of MI, and particularly in-hospital mortality rate and the effective factors. AIM: To determine the epidemiological pattern of MI based on person-, time-, place-, and mortality-associated risk factors...
2015: Kardiologia Polska
Ali Ahmadi, Arsalan Khaledifar, Homeira Sajjadi, Hamid Soori
INTRODUCTION: Since no hospital-based, nationwide study has been yet conducted on the association between risk factors and in-hospital mortality due to myocardial infarction (MI) by educational level in Iran, the present study was conducted to investigate relationship between risk factors and in-hospital mortality due to MI by educational level. METHODS: In this nationwide hospital-based, prospective analysis, follow-up duration was from definite diagnosis of MI to death...
2014: International Journal for Equity in Health
A Kovindha, P Kammuang-lue
OBJECTIVE: To report and discuss the case of an incomplete paraplegic patient who died of pulmonary embolism (PE) aggravated by manual muscle testing. SETTING: Acute spinal ward, Maharaj Hospital, Chiang Mai, Thailand. CASE REPORT: A 79-year-old man suffering from chest trauma, fractured ribs and a fracture of T11 with incomplete paraplegia, American Spinal Injury Association impairment scale D. Intercostal tubes were inserted at both sides due to haemothorax...
November 2014: Spinal Cord
Shuji Hashiguchi, Katsuhito Adachi, Toshio Inui, Yoshiharu Arii, Setsuko Kashiwagi, Miho Saito, Noriko Kagawa, Hisaomi Kawai
In this study, we compared the clinicopathological findings of two autopsy cases of patients with calpainopathy (LGMD2A) from different families. The patient in case 1 was a 72-year-old man with a history of type 2 diabetes mellitus. He exhibited recent memory impairments from the age of 70. ECG revealed an incomplete right bundle branch block. A homozygous frameshift mutation c.1796dupA was found in the CAPN3 gene. Cause of death was respiratory insufficiency and heart failure. The patient in case 2 was a 70-year-old man with a history of hypertension...
September 2014: Brain and Nerve, Shinkei Kenkyū No Shinpo
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