Right bundle branch block electrocardiogram: Difference between revisions

Jump to navigation Jump to search
← Older editNewer edit →
VisualWikitext
Raviteja Reddy Guddeti (talk | contribs)
nocaptcha
20,348 edits
No edit summary
Raviteja Reddy Guddeti (talk | contribs)
nocaptcha
20,348 edits
Line 21: Line 21:
== EKG Examples==
== EKG Examples==


<div align="left">
{| align="center"
<gallery heights="175" widths="175">
|-valign="top"
Image:RBBB1.png|The main characteristics of [[Right Bundle Branch Block]] in V1
| [[Image:RBBB1.png|thumb|The main characteristics of [[Right Bundle Branch Block]] in V1]]
Image:ECG RBTB LAtrD.jpg|[[Right Bundle Branch Block]]
| [[Image:ECG RBTB LAtrD.jpg|thumb|[[Right Bundle Branch Block]]]]
</gallery>
|}
</div>




<div align="left">
{| align="center"
<gallery heights="175" widths="175">
|-valign="top"
Image:RBBB.PNG|[[Right Bundle Branch Block]]
| [[Image:RBBB.PNG|thumb|[[Right Bundle Branch Block]]]]
Image:C13.ht13.jpg|[[Right Bundle Branch Block]]. 
| [[Image:C13.ht13.jpg|thumb|[[Right Bundle Branch Block]]]]
</gallery>
|}
</div>




<div align="left">
{| align="center"
<gallery heights="175" widths="175">
|-valign="top"
Image:C14.ht14.jpg|[[Right Bundle Branch Block]]. <small>  [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]</small>
| [[Image:C14.ht14.jpg|thumb|[[Right Bundle Branch Block]]. <small>  [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]</small>]]
Image:C15.ht15.jpg|[[Right Bundle Branch Block]]. <small>  [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]</small>
| [[Image:C15.ht15.jpg|thumb|[[Right Bundle Branch Block]]. <small>  [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]</small>]]
</gallery>
|}
</div>




<div align="left">
{| align="center"
<gallery heights="175" widths="175">
|-valign="top"
Image:C16.ht16.jpg|[[Right Bundle Branch Block]]. <small>  [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]</small>
| [[Image:C16.ht16.jpg|thumb|[[Right Bundle Branch Block]]. <small>  [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]</small>]]
Image:C17.ht17.jpg|[[Right Bundle Branch Block]]. <small>  [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]</small>
| [[Image:C17.ht17.jpg|thumb|[[Right Bundle Branch Block]]. <small>  [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]</small>]]
</gallery>
|}
</div>




<div align="left">
{| align="center"
<gallery heights="175" widths="175">
|-valign="top"
Image:C18.ht18.jpg|[[Right Bundle Branch Block]] with [[First Degree AV Block|first degree AV block]]. <small>  [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]</small>
| [[Image:C18.ht18.jpg|thumb|[[Right Bundle Branch Block]] with [[First Degree AV Block|first degree AV block]]. <small>  [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]</small>]]
Image:C22.ht22.jpg|[[Right Bundle Branch Block]] with RA hypertrophy. <small>  [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]</small>
| [[Image:C22.ht22.jpg|thumb|[[Right Bundle Branch Block]] with RA hypertrophy. <small>  [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]</small>]]
</gallery>
|}
</div>




<div align="left">
{| align="center"
<gallery heights="175" widths="175">
|-valign="top"
Image:RBBB_inf_MI.jpg|Patient with [[RBBB]] and [[Acute MI|inferior MI]]. Note to left axis deviation.
| [[Image:RBBB_inf_MI.jpg|thumb|Patient with [[RBBB]] and [[Acute MI|inferior MI]]. Note to left axis deviation.]]
Image:RBBB_inf_MI_V4R.jpg|The same patient. Lead V4R. ST elevation shown.
| [[Image:RBBB_inf_MI_V4R.jpg|thumb|The same patient. Lead V4R. ST elevation shown.]]
</gallery>
|}
</div>




<div align="left">
{| align="center"
<gallery heights="175" widths="175">
|-valign="top"
Image:RBBB_inf_MI_baseline.jpg|The same patient before [[acute MI]] developed. Horizontal axis shown.
| [[Image:RBBB_inf_MI_baseline.jpg|thumb|The same patient before [[acute MI]] developed. Horizontal axis shown.]]
Image:R11.ht36.jpg|[[Supraventricular tachycardia]] with [[RBBB]]. <small>  [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]</small>
| [[Image:R11.ht36.jpg|thumb|[[Supraventricular tachycardia]] with [[RBBB]]. <small>  [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]</small>]]
</gallery>
|}
</div>




<div align="left">
{| align="center"
<gallery heights="175" widths="175">
|-valign="top"
Image:cominf12.jpg|Old [[Acute MI|Anterior MI]] with [[RBBB]]. <small>  [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]</small>
| [[Image:cominf12.jpg|thumb|Old [[Acute MI|Anterior MI]] with [[RBBB]]. <small>  [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]</small>]]
Image:cominf19.jpg|Old [[Acute MI|Inferior MI]] and [[Acute MI|Anterior MI] with [[RBBB]] and [[LAFB]]. <small>  [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]</small>
| [[Image:cominf19.jpg|thumb|Old [[Acute MI|Inferior MI]] and [[Acute MI|Anterior MI]] with [[RBBB]] and [[LAFB]].]]
</gallery>
|}
</div>




<div align="left">
{| align="center"
<gallery heights="175" widths="175">
|-valign="top"
Image:cominf5.jpg|Old [[Acute MI|Inferior MI]] and [[RBBB]]. <small>  [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]</small>
| [[Image:cominf5.jpg|thumb|Old [[Acute MI|Inferior MI]] and [[RBBB]]. <small>  [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]</small>]]
Image:c3.htm3.jpg|[[RBBB]] + [[LAFB]]. <small>  [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]</small>
| [[Image:c3.htm3.jpg|thumb|[[RBBB]] + [[LAFB]]. <small>  [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]</small>]]
</gallery>
|}
</div>




<div align="left">
{| align="center"
<gallery heights="175" widths="175">
|-valign="top"
Image:c19.ht19.jpg|[[RBBB]] + [[LAFB]] + [[First Degree AV Block]]. <small>  [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]</small>
| [[Image:c19.ht19.jpg|thumb|[[RBBB]] + [[LAFB]] + [[First Degree AV Block]]. <small>  [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]</small>]]
Image:c20.ht20.jpg|[[RBBB]] + [[LAFB]]. <small>  [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]</small>
| [[Image:c20.ht20.jpg|thumb|[[RBBB]] + [[LAFB]]. <small>  [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]</small>]]
</gallery>
| [[Image:c21.ht21.jpg|thumb|[[RBBB]] + [[LPFB]]. <small>  [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]</small>]]
</div>
|}
 
 
<div align="left">
<gallery heights="175" widths="175">
Image:c21.ht21.jpg|[[RBBB]] + [[LPFB]]. <small>  [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]</small>
</gallery>
</div>


==References==
==References==

Revision as of 15:04, 24 August 2012

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 electrocardiogram 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 electrocardiogram

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 electrocardiogram

CDC on Right bundle branch block electrocardiogram

Right bundle branch block electrocardiogram in the news

Blogs on Right bundle branch block electrocardiogram

Directions to Hospitals Treating Right bundle branch block

Risk calculators and risk factors for Right bundle branch block electrocardiogram

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Overview

ECG

  • The heart rhythm must be supraventricular in origin
  • The QRS axis can be either normal, or right or left axis deviation may be present.
  • The QRS duration must be = or > 120 ms
    • For complete RBBB, the patient's age must be taken into account to determine if the duration of the QRS complex is prolonged for the patient's age.
      • Maximum QRS durations are 0.07 s for newborns <6 days, 0.08 s for patients aged 1 week to 7 years, and 0.09 s for patients aged 7-15 years.
  • There should be a terminal R wave in lead V1-V3R (e.g., R, rR', rsR', rSR' or qR')
    • This pattern is present because the initial R wave represents septal activation, the S wave represents left ventricular activation, and the R' represents activation of the right ventricle from the septum and left ventricle.
  • There should be a slurred S wave in leads I and V6. This represent left ventricular activation.
    • Because transmission of the electrical impulse through the left bundle is normal, this results in normal depolarization of the septum and the left ventricle. As a result, there is an initial R wave in lead I and V1 and the Q wave in V6.

The T wave should be deflected opposite the terminal deflection of the QRS complex. This is known as appropriate T wave discordance with bundle branch block. A concordant T wave may suggest ischemia or myocardial infarction.

EKG Examples

The main characteristics of Right Bundle Branch Block in V1
File:ECG RBTB LAtrD.jpg
Right Bundle Branch Block


Right Bundle Branch Block
Right Bundle Branch Block


Right Bundle Branch Block. Image courtesy of Dr Jose Ganseman
Right Bundle Branch Block. Image courtesy of Dr Jose Ganseman


Right Bundle Branch Block. Image courtesy of Dr Jose Ganseman
Right Bundle Branch Block. Image courtesy of Dr Jose Ganseman


Right Bundle Branch Block with first degree AV block. Image courtesy of Dr Jose Ganseman
Right Bundle Branch Block with RA hypertrophy. Image courtesy of Dr Jose Ganseman


Patient with RBBB and inferior MI. Note to left axis deviation.
The same patient. Lead V4R. ST elevation shown.


The same patient before acute MI developed. Horizontal axis shown.
Supraventricular tachycardia with RBBB. Image courtesy of Dr Jose Ganseman


Old Anterior MI with RBBB. Image courtesy of Dr Jose Ganseman
Old Inferior MI and Anterior MI with RBBB and LAFB.


Old Inferior MI and RBBB. Image courtesy of Dr Jose Ganseman
RBBB + LAFB. Image courtesy of Dr Jose Ganseman


RBBB + LAFB + First Degree AV Block. Image courtesy of Dr Jose Ganseman
RBBB + LAFB. Image courtesy of Dr Jose Ganseman
RBBB + LPFB. Image courtesy of Dr Jose Ganseman

References

Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Right_bundle_branch_block_electrocardiogram&oldid=696536"