Right bundle branch block causes: Difference between revisions

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__NOTOC__
__NOTOC__
{{Right bundle branch block}}
{{Right bundle branch block}}
{{CMG}}; {{AE}} {{CZ}}
{{CMG}}; {{AE}} {{CZ}}; {{RT}}; {{AN}}; {{AO}}
 
==Overview==
Right bundle branch block can result from various causes which include: [[cardiovascular]] (e.g. [[Atrial septal defect]], [[cardiomyopathy]], [[coronary artery disease]], [[Ebstein anomaly]]); iatrogenic (e.g. [[Cardiac catheterization]], [[cardiac transplantation]], [[Ventricular septal defect surgery|post cardiac surgery]]); [[infectious]] (e.g. [[Chagas disease]], [[HIV]], [[infective endocarditis]], [[Lyme disease]]); [[pulmonary]] (e.g. [[COPD]], [[cor pulmonale ]], [[pulmonary embolism]], [[pulmonary hypertension]]), and many other disease conditions.


==Causes==
==Causes==
* [[Pulmonary Embolism|Acute pulmonary embolism]] - acute rise in right ventricular pressures
===Life Threatening Causes===
* [[Atrial septal defect]]
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
* Blunt [[trauma]]
*[[Citalopram|Citalopram toxicity]]
* [[Ddx:Cardiomyopathy|Cardiomyopathy]]
*[[Cocaine abuse]]
* [[COPD]]
*[[Heart failure]]
* [[Cor pulmonale]] - chronically increased right ventricular pressure and/or [[right ventricular hypertrophy]]
*[[Hyperkalemia]]
* [[Coronary heart disease]]
*[[Myocardial infarction]]
* Familial
*[[Pulmonary embolism]]
* [[Hypertension]]
 
* [[Lev's disease]]
===Common Causes===
* [[Myocardial infarction]]
*[[Cocaine abuse]]
* [[Myocarditis]]
*[[COPD]]
* [[Polymyositis]]
*[[Cor pulmonale]]  
* Prenatal exposure to [[HIV]] type 1 may cause right anterior [[hemiblock]].
*[[Coronary heart disease]]
* Septal reduction therapy with ethanol ablation in patients with [[hypertrophic cardiomyopathy]]
*[[Heart failure]]
* Surgery for correction of [[congenital heart disease]] is the most common cause of RBBB among children in the 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]].
*[[Hyperkalemia]]
* [[Valvular heart disease]]
*[[Hypertension]]
*[[Myocarditis]]
*[[Pulmonary embolism]]
 
===Causes by Organ System===
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" |  [[Atrial septal defect]], [[cardiomyopathy]], [[coronary artery disease]], [[Ebstein anomaly]], [[heart failure]], [[hypertension]], [[left ventricular noncompaction]], [[Lev's disease]], [[myocardial infarction]], [[myocarditis]], [[valvular heart disease]]
|-
|-bgcolor="LightSteelBlue"
| '''Chemical / poisoning'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"| [[Naloxone]], [[oxycodone]], [[propafenone]], [[ritonavir]]  
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| [[Ebstein anomaly]], [[Fabry disease]], [[familial]], [[Kearns-Sayre syndrome]], [[muscular dystrophy]], [[myotonic dystrophy]]
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| [[Cardiac catheterization]], [[cardiac transplantation]], [[Ventricular septal defect surgery|post cardiac surgery]], [[pulmonary artery catheterization]], [[Hypertrophic cardiomyopathy alcohol septal ablation|septal ablation]], [[thrombolytic therapy]], [[transjugular intrahepatic portosystemic shunt]]
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"| [[Chagas disease]], [[HIV]], [[infective endocarditis]], [[Lyme disease]]  
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal / Ortho'''
|bgcolor="Beige"| [[Kearns-Sayre syndrome]], [[muscular dystrophy]], [[myotonic dystrophy]]
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| [[Kearns-Sayre syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional / Metabolic'''
|bgcolor="Beige"| [[Fabry disease]]
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Opthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Overdose / Toxicity'''
|bgcolor="Beige"| [[Citalopram|Citalopram toxicity]], [[cocaine abuse]]
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| [[COPD]], [[cor pulmonale ]], [[pulmonary embolism]], [[pulmonary hypertension]], [[pulmonic stenosis]], [[sarcoidosis]]  
|-
|-bgcolor="LightSteelBlue"
| '''Renal / Electrolyte'''
|bgcolor="Beige"| [[Hyperkalemia]]
|-
|-bgcolor="LightSteelBlue"
| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"| [[Polymyositis]], [[sarcoidosis]], [[systemic lupus erythematosus]]
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"| [[Commotio cordis|Trauma]]
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| No underlying causes
|-
|}


===Transient RBBB===
===Causes in Alphabetical Order===
* [[Hyperkalemia]]
{{col-begin|width=80%}}
* Mechanical damage during right heart [[catheterization]] - observed in 5% of the patients. Resolves when the catheter is removed.  Associated [[LBBB]] can cause [[complete heart block]] in such situations leading to [[cardiac arrest]].  A temporary pacemaker is inserted during the procedure in patients with LBBB to prevent sudden cardiac arrest.
{{col-break|width=33%}}
* Occasionally following thrombolytic therapy in patients with [[myocardial infarction]] and new RBBB
*[[Atrial septal defect]]
* [[Pulmonary embolism]]
*[[Cardiac catheterization]]
* [[Premature atrial contraction]]s or [[supraventricular tachycardia]] may cause a transient form of 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.
*[[Cardiac transplantation]]
* [[Trauma]]
*[[Cardiomyopathy]]
*[[Chagas disease]]
*[[Citalopram|Citalopram toxicity]]
*[[Cocaine abuse]]
*[[COPD]]
*[[Cor pulmonale]]
*[[Coronary artery disease]]
*[[Ebstein anomaly]]
*[[Fabry disease]]
*[[Familial]]
*[[Heart failure]]
*[[HIV]]
*[[Hyperkalemia]]
*[[Hypertension]]
*[[Infective endocarditis]]
*[[Left ventricular noncompaction]]
*[[Kearns-Sayre Syndrome]]
*[[Lev's disease]]
*[[Lyme disease]]
{{col-break|width=33%}}
*[[Muscular dystrophy]]
*[[Myocardial infarction]]
*[[Myocarditis]]
*[[Myotonic dystrophy]]
*[[Naloxone]]
*[[Oxycodone]]
*[[Polymyositis]]
*[[Ventricular septal defect surgery|Post cardiac surgery]]
*[[Propafenone]]
*[[Pulmonary artery catheterization]]
*[[Pulmonary embolism]]
*[[Pulmonary hypertension]]
*[[Pulmonic stenosis]]
*[[Ritonavir]]
*[[Sarcoidosis]]
*[[Hypertrophic cardiomyopathy alcohol septal ablation|Septal ablation]]
*[[Systemic lupus erythematosus]]
*[[Thrombolytic therapy]]
*[[Transjugular intrahepatic portosystemic shunt]]
*[[Commotio cordis|Trauma]]
*[[Valvular heart disease]]
{{col-end}}


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Needs overview]]
 
[[Category:Crowdiagnosis]]
[[Category:Cardiology]]
[[Category:Up-To-Date]]
[[Category:Up-To-Date cardiology]]
[[Category:Arrhythmia]]
[[Category:Electrophysiology]]
[[Category:Electrophysiology]]
[[Category:Disease]]
[[Category:Disease]]
[[Category:Cardiology]]
 
[[Category:Emergency medicine]]
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Latest revision as of 23:09, 22 August 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]; Raviteja Guddeti, M.B.B.S. [3]; Aarti Narayan, M.B.B.S [4]; Ayokunle Olubaniyi, M.B,B.S [5]

Overview

Right bundle branch block can result from various causes which include: cardiovascular (e.g. Atrial septal defect, cardiomyopathy, coronary artery disease, Ebstein anomaly); iatrogenic (e.g. Cardiac catheterization, cardiac transplantation, post cardiac surgery); infectious (e.g. Chagas disease, HIV, infective endocarditis, Lyme disease); pulmonary (e.g. COPD, cor pulmonale , pulmonary embolism, pulmonary hypertension), and many other disease conditions.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Causes by Organ System

Cardiovascular Atrial septal defect, cardiomyopathy, coronary artery disease, Ebstein anomaly, heart failure, hypertension, left ventricular noncompaction, Lev's disease, myocardial infarction, myocarditis, valvular heart disease
Chemical / poisoning No underlying causes
Dermatologic No underlying causes
Drug Side Effect Naloxone, oxycodone, propafenone, ritonavir
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic Ebstein anomaly, Fabry disease, familial, Kearns-Sayre syndrome, muscular dystrophy, myotonic dystrophy
Hematologic No underlying causes
Iatrogenic Cardiac catheterization, cardiac transplantation, post cardiac surgery, pulmonary artery catheterization, septal ablation, thrombolytic therapy, transjugular intrahepatic portosystemic shunt
Infectious Disease Chagas disease, HIV, infective endocarditis, Lyme disease
Musculoskeletal / Ortho Kearns-Sayre syndrome, muscular dystrophy, myotonic dystrophy
Neurologic Kearns-Sayre syndrome
Nutritional / Metabolic Fabry disease
Obstetric/Gynecologic No underlying causes
Oncologic No underlying causes
Opthalmologic No underlying causes
Overdose / Toxicity Citalopram toxicity, cocaine abuse
Psychiatric No underlying causes
Pulmonary COPD, cor pulmonale , pulmonary embolism, pulmonary hypertension, pulmonic stenosis, sarcoidosis
Renal / Electrolyte Hyperkalemia
Rheum / Immune / Allergy Polymyositis, sarcoidosis, systemic lupus erythematosus
Sexual No underlying causes
Trauma Trauma
Urologic No underlying causes
Dental No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order

References


Template:WikiDoc Sources

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