Right bundle branch block: Difference between revisions

	Right bundle branch block Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Right bundle branch block from other Diseases
Epidemiology and Demographics
Risk Factors
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
EKG Examples
Echocardiography
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Right bundle branch block On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Right bundle branch block All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Right bundle branch block
CDC on Right bundle branch block
Right bundle branch block in the news
Blogs on Right bundle branch block
Directions to Hospitals Treating Right bundle branch block
Risk calculators and risk factors for Right bundle branch block

	Right bundle branch block;
	ECG characteristics of a typical RBBB showing wide QRS complexes with a terminal R wave in lead V1 and slurred S wave in lead V6.

VisualWikitext

Latest revision as of 21:27, 20 August 2013

For patient information click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Aarti Narayan, M.B.B.S [3]; Raviteja Guddeti, M.B.B.S. [4]

Synonyms and keywords: RBBB; bundle branch block right; rt bundle branch block

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Right bundle branch block from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

Treatment

Case Studies

Case #1

Related Chapters

Template:WH Template:WS

@@ Line 4: / Line 4: @@
    Image          = Right bundle branch block ECG characteristics.png|
    Caption        = ECG characteristics of a typical RBBB showing wide QRS complexes with a terminal R wave in lead V1 and slurred S wave in lead V6.|
-  DiseasesDB     = 11620 |
-  ICD10          = {{ICD10|I|45|1|i|30}} |
-  ICD9           = |
-  ICDO           = |
-  OMIM           = |
-  MedlinePlus    = |
-  eMedicineSubj  = |
-  eMedicineTopic = |
-  MeshID         = |
 }}
 {{Right bundle branch block}}
+'''For patient information click [[Heart block (patient information)|here]]'''
-{{CMG}} '''Associate Editor-In-Chief:''' {{CZ}}
+{{CMG}}; {{AE}} {{CZ}}; {{AN}}; {{RT}}
-{{SK}} RBBB
+{{SK}} RBBB; bundle branch block right; rt bundle branch block
-==Overview==
-'''Right bundle branch block (RBBB)''' results from a defect in the heart's electrical conduction system. There is a delay in failure of transmission of electrical impulses down the right bundle of the heart.  As a result, the right ventricle depolarizes by an alternate mechanism. This is by means of cell-to-cell conduction. These cell to cell conduction impulses spread more slowly than usual from the interventricular septum to the [[left ventricle]] and to the [[right ventricle]]. This delay in conduction results in the characteristic [[ECG]] pattern which is a wide and notched [[QRS]]. Although conduction down the right bundle is delayed, conduction down the left bundle  is normal. As result, the interventricular septum and [[left ventricle]] depolarize in the normal fashion.
-==Pathophysiology==
-Three types of [[RBBB]] have been identified based upon electrophysiologic studies.
-In  each of the three types of RBBB, the surface ECG pattern remains the same.
-'''1. Proximal, or central, RBBB:'''
-This type of conduction defect occurs when the conduction block is located just distal to the bundle of His in the superior aspect of the right bundle branch. This type of block occurs when the proximal bundle is injured during surgery for an inlet or membranous [[ventricular septal defect]] ([[VSD]]).
-'''2. Interruption between the proximal and distal aspects of the right bundle branch:'''
-This type of right bundle branch block occurs when the impulse is interrupted between the proximal and distal aspects of the right bundle branch. This type of bright bundle branch block is most commonly observed after surgical division of the moderator band.
-'''3. Distal RBBB:'''
-This form is observed when distal ramifications of the right bundle are disrupted during right ventriculotomy or resection of muscle bundles in the right ventricular outflow tract.
-===Genetics ===
-There can be familial cases of [[right bundle branch block]] such as that observed in 4 Lebanese families and the abnormality was mapped to chromosome 19.
-There is a subset of patients with [[Brugada syndrome]] who have mutations in SCN5A, the gene encoding for the voltage-gated cardiac sodium channel.
-===Associated syndromes===
-*[[Duchenne muscular dystrophy]]
-*[[Myotonic dystrophy]] Other ECG findings include [[first-degree AV block]], [[left anterior fascicular block]], and intraventricular conduction delay. Patients may have arrhythmias and/or [[Stokes-Adams attacks]].
-*[[Kearns-Sayre Syndrome]]
-*[[Brugada syndrome]]: This syndrome is due to a channelopathy mediated by the SCN5A gene. It is important to note that the RBBB pattern seen in patients with this syndrome is not actually RBBB but is  instead due to a repolarization abnormality.  In this syndrome, the ECG shows ST-segment elevation in leads V1-V3. [[Cocaine]] consumption  and / or the use of the antiarrhythmic [[propafenone]] may unmask the ECG findings  of [[Brugada syndrome]].
-==Causes of Right Bundle Branch Block==
-*Surgery for correction of congenital heart disease is the most common cause of [[RBBB]] among children any United States. This includes surgery for repair of an isolated [[VSD]] or another [[congenital heart disease]] that includes a [[VSD]] (eg, double-chambered right ventricle, AV canal defect, or [[tetralogy of Fallot]]). The incidence of [[RBBB]] varies and ranges from 25-81% after repair of a VSD to 60-100% after repair of [[tetralogy of Fallot]]. The risk of [[RBBB]] after surgery varies depending upon the proximity of the [[VSD]] to the His-Purkinje system.
-*Blunt [[trauma]]
-*[[Polymyositis]]
-*[[Premature atrial contraction]]s or supraventricular tachycardia may cause a transient form up right bundle branch block. This occurs when a premature impulse is conducted from the AV node to the His bundle while the right bundle branch remains in its refractory period, but the left bundle is not. As a result, conduction down the right bundle branch is delayed or blocked.
-*Prenatal exposure to each one HIV type 1 may cause right anterior hemiblock.
-* Familial
-==Differential Diagnosis==
-* [[Pulmonary Embolism|Acute pulmonary embolism]]
-* [[Atrial septal defect]]
-* [[Ddx:Cardiomyopathy|Cardiomyopathy]]
-* [[Cor Pulmonale]]
-* [[Coronary Heart Disease]]
-* [[Lenegre's Disease]]
-* [[Lev's Disease]]
-* [[STEMI|Myocardial Infarction]]
-* [[Myocarditis]]
-----
-__NOEDITSECTION__
 ==[[Right bundle branch block overview|Overview]]==
 ==[[Right bundle branch block historical perspective|Historical Perspective]]==
+==[[Right bundle branch block classification|Classification]]==
 ==[[Right bundle branch block pathophysiology|Pathophysiology]]==
 ==[[Right bundle branch block causes|Causes]]==
+==[[Right bundle branch block differential diagnosis|Differentiating Right bundle branch block from other Diseases]]==
 ==[[Right bundle branch block epidemiology and demographics|Epidemiology and Demographics]]==
@@ Line 95: / Line 32: @@
 ==Diagnosis==
-[[Right bundle branch block history and symptoms|History and Symptoms ]] | [[ Right bundle branch block physical examination|Physical Examination]] | [[Right bundle branch block laboratory findings|Laboratory Findings]] | [[Right bundle branch block electrocardiogram|Electrocardiogram]] | [[Right bundle branch block echocardiography|Echocardiography]] | [[Right bundle branch block other imaging findings|Other Imaging Findings]] | [[Right bundle branch block other diagnostic studies|Other Diagnostic Studies]]
+[[Right bundle branch block history and symptoms|History and Symptoms ]] | [[ Right bundle branch block physical examination|Physical Examination]] | [[Right bundle branch block laboratory findings|Laboratory Findings]] | [[Right bundle branch block electrocardiogram|Electrocardiogram]] | [[Right bundle branch block EKG examples|EKG Examples]] | [[Right bundle branch block echocardiography|Echocardiography]] | [[Right bundle branch block other imaging findings|Other Imaging Findings]] | [[Right bundle branch block other diagnostic studies|Other Diagnostic Studies]]
 ==Treatment==
@@ Line 104: / Line 42: @@
 ==Related Chapters==
+*[[Electrical conduction system of the heart]]
+*[[Electrocardiogram]] (ECG or EKG)
+*[[SA node]]
+*[[AV node]]
+*[[Second degree AV block]]
+*[[Third degree AV block]]
+*[[Bundle branch block]]
+*[[Left bundle branch block]]
+*[[Hemiblock]]
+*[[Infra-Hisian Block]]
+*[[Left anterior fascicular block]]
+*[[Left posterior fascicular block]]
-* [[Bundle branch block]]
+{{WH}}
-* [[Left bundle branch block]]
+{{WS}}
-{{Electrocardiography}}
-{{Circulatory system pathology}}
-{{Link_FA|de}}
 [[Category:Electrophysiology]]
@@ Line 117: / Line 62: @@
 [[Category:Cardiology]]
 [[Category:Emergency medicine]]
+[[Category:Arrhythmia]]


Right bundle branch block
ECG characteristics of a typical RBBB showing wide QRS complexes with a terminal R wave in lead V1 and slurred S wave in lead V6.

Right bundle branch block: Difference between revisions

Latest revision as of 21:27, 20 August 2013

Diagnosis

Treatment

Case Studies

Related Chapters

Navigation menu