Left bundle branch block natural history, complications and prognosis: Difference between revisions

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==Complications==
==Complications==
* [[Pulmonary arterial line]] placement <ref name="pmid3675104">{{cite journal |author=Morris D, Mulvihill D, Lew WY |title=Risk of developing complete heart block during bedside pulmonary artery catheterization in patients with left bundle-branch block |journal=[[Archives of Internal Medicine]] |volume=147 |issue=11 |pages=2005–10 |year=1987 |month=November |pmid=3675104 |doi= |url=http://archinte.jamanetwork.com/article.aspx?volume=147&page=2005 |issn= |accessdate=2012-10-17}}</ref> in a patient with LBBB can result in a [[complete heart block]] if the right bundle branch is traumatized during the process.
* [[Pulmonary arterial line]] placement <ref name="pmid3675104">{{cite journal |author=Morris D, Mulvihill D, Lew WY |title=Risk of developing complete heart block during bedside pulmonary artery catheterization in patients with left bundle-branch block |journal=[[Archives of Internal Medicine]] |volume=147 |issue=11 |pages=2005–10 |year=1987 |month=November |pmid=3675104 |doi= |url=http://archinte.jamanetwork.com/article.aspx?volume=147&page=2005 |issn= |accessdate=2012-10-17}}</ref> in a patient with LBBB can result in a [[complete heart block]] if the right bundle branch is traumatized during the process.
* Progression to higher degree AV block: It was shown in the Swedish study that the risk of progression was more pronounced in left block than in right bundle branch block.
* Progression to higher degree AV block: It was shown in the Swedish study that the risk of progression was more pronounced in left block than in [[right bundle branch block]].
* [[Bradycardia]]
* Delay in the diagnosis of [[MI]]: Presence of LBBB can delay the diagnosis of an acute MI.
* [[Sudden cardiac death]] is a potential complication when associated with a heart attack.


==Prognosis==
==Prognosis==

Revision as of 11:36, 29 April 2013

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]

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Complications

Prognosis

Age Under 50 Years

In patients under the age of 50, LBBB does not appear to be associated with an adverse prognosis.

Age Over 50 Years

It is notable that when LBBB is the presenting feature of an acute MI, the patient will not present with any chest pain half the time. Unfortunately, patients whose only manifestation of an acute MI is a left bundle branch block are less frequently treated with reperfusion therapy, and they have a worse prognosis.[2] A large Swedish study in men more than 45 years old with LBBB who were followed-up for over 25 years, showed both a much higher risk for developing high degree atrioventricular block and a markedly higher hazard ratio for all-cause mortality than individuals with right bundle branch block.

References

  1. Morris D, Mulvihill D, Lew WY (1987). "Risk of developing complete heart block during bedside pulmonary artery catheterization in patients with left bundle-branch block". Archives of Internal Medicine. 147 (11): 2005–10. PMID 3675104. Retrieved 2012-10-17. Unknown parameter |month= ignored (help)
  2. Shlipak M, Go A, Frederick P, Malmgren J, Barron H, Canto J. Treatment and outcomes of left bundle-branch block patients with myocardial infarction who present without chest pain. J Am Coll Cardiol. 2000;36(3):706-712.

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