Left posterior fascicular block: Difference between revisions

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{{Infobox_Disease |
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  Name          = {{PAGENAME}} |
'''For patient information, click [[Heart block (patient information)|here]]'''
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  ICD10          = {{ICD10|I|44||i|30}}-{{ICD10|I|45||i|30}} |
  ICD9          = {{ICD9|426.9}} |
  ICDO          = |
  OMIM          = |
  MedlinePlus    = |
  eMedicineSubj  = |
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  MeshID        = D006327 |
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{{Left posterior fascicular block}}
{{Left posterior fascicular block}}
{{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}}
{{CMG}}; {{AE}} {{CZ}}
 
{{SK}} LPFB; left posterior hemiblock; LPH
 
== [[Left posterior fascicular block overview|Overview]] ==
 
== [[Left posterior fascicular block historical perspective|Historical Perspective]] ==


{{SK}} LPFB; Left Posterior Hemiblock; LPH
== [[Left posterior fascicular block pathophysiology|Pathophysiology]] ==


==Overview==
== [[Left posterior fascicular block causes|Causes]] ==
Left posterior fascicular block is characterized by a mean frontal plane axis of >90° in the absence of other causes of right axis deviation. Left posterior hemiblock (left posterior fascicular block) is infrequent.<ref>ABC of Clinical Electrocardiography, Morris F, Edhouse J, Brady WJ, Camm J, 2003</ref> Its seen either in the setting of either [[RCA]] or [[LAD]] related pathologies.


==Anatomical Course of the Left Fascicle==
== [[Left posterior fascicular block differential diagnosis|Differentiating Left posterior fascicular block from other Diseases]] ==


The left posterior fascicle is a [[distal]] extension of the left main bundle and courses posteriorly toward the posterior [[papillary muscle]] which is located in the posterior, medial and inferior aspect of [[left ventricle]] and inferoposteriorly toward the left ventricular free wall. <ref>Pathophysiology of Heart Disease, Lilly LS, 4th edition, 2006</ref>
== [[Left posterior fascicular block epidemiology and demographics|Epidemiology and Demographics]] ==


==Blood Supply of the Left Posterior Fascicle==
== [[Left posterior fascicular block risk factors|Risk Factors]] ==
The proximal part of the left posterior fascicle is supplied by the artery supplying the atrioventricular (AV) node (often the [[right coronary artery]]) and, at times, by septal branches of the [[left anterior descending]] ([[LAD]]) artery.


==Causes==
== [[Left posterior fascicular block natural history, complications and prognosis|Natural History, Complications and Prognosis]] ==
*[[Congenital aortic stenosis]]
*[[Congenital heart disease]] repair
*[[Endocarditis]]
*[[Myocarditis]] secondary to [[diphtheria]]


==Diagnosis==
== Diagnosis ==


The diagnosis is often made in the context of previous ECGs. The frontal QRS axis is  rightward and there are no other potential causes of [[right axis deviation]] such as [[right ventricular hypertrophy]] and prior lateral [[myocardial infarction]].
[[Left posterior fascicular block history and symptoms|History and Symptoms]] | [[Left posterior fascicular block physical examination|Physical Examination]] | [[Left posterior fascicular block laboratory findings|Laboratory Findings]] | [[Left posterior fascicular block chest x ray|Chest X Ray]] | [[Left posterior fascicular block electrocardiogram|Electrocardiogram]] | [[Left posterior fascicular block echocardiography or ultrasound|Echocardiography]] | [[Left posterior fascicular block other  imaging findings|Other Imaging Findings]] | [[Left posterior fascicular block other diagnostic studies|Other Diagnostic Studies]]


*[[QRS]] axis of 100 to 180 degrees
== Treatment ==
*[[QRS duration]] 80-100 msec (usually normal or slightly widened qRS complex)
*Deep S in lead I and aVL (rS in I and aVL)
*qR in II, III, and aVF


==Examples==
[[Left posterior fascicular block medical therapy|Medical Therapy]] | [[Left posterior fascicular block surgery|Surgery]] | [[Left posterior fascicular block primary prevention|Primary Prevention]] | [[Left posterior fascicular block secondary prevention|Secondary Prevention]] | [[Left posterior fascicular block cost-effectiveness of therapy|Cost Effectiveness of Therapy]] | [[Left posterior fascicular block future or investigational therapies|Future or Investigational Therapies]]


==References==
==Case Studies==
{{Reflist|2}}


==See Also==
[[Left posterior fascicular block case study one|Case #1]]


{{Electrocardiography}}
{{Electrocardiography}}
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[[Category:Electrophysiology]]
[[Category:Electrophysiology]]
[[Category:Cardiology]]
[[Category:Cardiology]]
[[Category:Intensive care medicine]]
[[Category:Disease]]

Latest revision as of 18:45, 7 February 2013

For patient information, click here

Left posterior fascicular block Microchapters

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Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Left posterior fascicular block from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Chest X Ray

Electrocardiogram

Echocardiography

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

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Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

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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]

Synonyms and keywords: LPFB; left posterior hemiblock; LPH

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Left posterior fascicular block from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Chest X Ray | Electrocardiogram | 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


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