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BUNDLE BRANCH BLOCKS (LBBB (Pathophysiology (may be present as a first…
BUNDLE BRANCH BLOCKS
LBBB
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can be subdivided into left anterior fascicular block (LAFB) and left posterior fascicular blocks (LPFB)
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Pathophysiology
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often associated with underlying heart disease and rarely occurs in patients with structurally normal hearts
ischaemia or degenerative damage can interrupt conduction through the right or left bundle branches. when this happens, the affected ventricle is unable to depolarise in the normal sequence so relies on a slower conduction pathway [myocyte to myocyte rather than purkinje fibres]
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MANAGEMENT
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Specific treatment not usually required although treatment for e.g. cardiomyopathy, where present, is indicated
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RBBB
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AETIOLOGY
COMMON CAUSES
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RV flow obstruction (right heart strain; pulmonary stenosis, pulmonary embolism)
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PATHOPHYSIOLOGY
Tends to occur proximally - due to close proximity to the subendocardial surface along which the proximal 2/3rds of Right Bundle Branch travels
this makes it highly susceptible to damage and any structural abnormalities (ie inc RV pressure asa result of RV hypertrophy or right heart strain) can lead to RBBB
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ECG
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Long S wave duration in V6, I
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