Intermittent left bundle branch block Syed Saad MD, Faran Polani MD, Paul Lelorier MD, Neeraj Jain MD.
Intermittent left bundle branch block is an uncommon electrocardiographic finding. It is mostly associated with coronary artery disease, blunt cardiac injury and infective endocarditis.
We present a case of 82-year-old Caucasian female with hypertension. She was referred to cardiology clinic for abnormal electrocardiogram (ECG) showing intermittent left bundle branch block. The mechanism is depicted below. She denied chest pain but endorsed dyspnea on exertion. Her physical examination was unremarkable except for a blood pressure of 182/86 mmHg. Blood work including complete blood count, creatinine, and electrolytes were within normal ranges. Chest radiogram was unremarkable. Echocardiogram demonstrated mild diastolic dysfunction and perfusion imaging was negative for ischemia. ECGs on subsequent visits showed similar findings with no further conduction abnormalities. With optimal management of blood pressure, her dyspnea on exertion improved substantially.
EKG: Sinus rhythm with intermittent left bundle branch block (LBBB) at 100 beats/ minute.
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