If the conduction of impulses in the His system changes, an extremely serious pathology occurs that disrupts the normal functioning of the heart. Bundle branch block (BNBB) leads to changes in the nature or complete interruption of the contractility of the heart zones.
Most often, minor blockades do not bother the patient at all and are detected during preventive examinations. However, in order to prevent the condition from getting worse, it is important to start timely treatment. To understand what the His bundle is, it is important to understand the physiology of the conduction system as a whole.
Conduction system of the heart
The heart is an amazing organ with a number of functions. One of them is the conduction function performed by the conduction system. It consists of several formations, namely:
Otherwise, this formation is called the Kisa-Flaca node, and it is from here that the impulse begins its journey. It is located between the vena cava, and more precisely, between their mouths. The length of this node is 10–15 mm, and the formation itself is represented by two types of cells. P cells are needed to create an impulse, and T cells are needed directly to carry it out.
Another name is the Aschoff-Tavara node, located in the right atrium. The length is half that of the previous knot. Also consists of T and P cells. Forms normal sinus rhythm.
One of the most important and largest formations of the conduction system of the heart. Consists of branching and initial segments. The latter is not associated with the myocardium. The branching one is divided into 2 large branches - right and left. Both of these legs run on both sides interventricular septum. The left one branches into 2 more branches, innervating the left ventricle. The right one is responsible for transmitting excitation to the right ventricle.
Further branching leads to the formation of this formation, which is responsible for the contractility of the ventricular myocardium.
The process of conducting an impulse itself goes through several stages:
It is worth noting that normally the pacemaker is the Kisa-Flaca node. Excitation centers of the second and third order can play the role of a driver only in conditions of formed pathology.
Types of blockades
If we talk directly about conduction disorders in the His bundle, then depending on the number of affected bundles, the blockade should be divided into the following:
The arborization blockade should also be highlighted. The violation is located in lower sections Purkinje fibers. Thus there is large number all kinds of blockades, which can be distinguished using an electrocardiographic examination (ECG).
Important: incomplete blockade of the right bundle branch often does not cause any symptoms and does not imply danger. In diagnostic terms, such conditions are quite complex and are detected exclusively by performing an ECG.
Bundle branch block rarely occurs as an independent condition. Mostly it appears due to some pathology. So, they highlight following reasons of this disease:
Thus, there are a number of reasons that lead to disturbances in the conduction system. To get rid of this problem, it is extremely important not only to identify the main etiological factor, but also to correct the underlying disease, which requires consultation with a doctor.
Symptoms of bundle branch blocks are:
It is worth noting that if there is an incomplete blockade of the right leg, the patient may not have any complaints at all. Its detection is possible only during an ECG examination, so it is determined during a preventive examination by the attending physician. This is why it is so important to visit specialists in a timely manner.
To make a diagnosis of incomplete or complete His bundle block, the doctor will need a number of data. The first thing that helps to suspect this problem is the patient’s complaints. So, the patient may complain of general weakness, shortness of breath, loss of consciousness. In some cases, chronic illnesses or the patient's lifestyle may play a role.
Auscultation plays an important role in the physical examination. In this case, violations can be detected heart rate. Percussion examination can reveal changes in the cardiac boundaries. In any case, most often this is a manifestation of the underlying disease, and therefore does not have much diagnostic significance.
The most important examination for this pathology is an ECG. More details about the manifestations can be found in the table.
| LOCATION OF BLOCKADS | ECG DATA |
|---|---|
| Right leg (hereinafter PN) | On the ECG, with blockade of the right bundle branch, a deviation of the electronic axis of the heart (EOS) to the right is noted. There is an expansion of the QRS complex. |
| Anterior branch of the left leg | Q waves are detected in the first lead, as well as an R wave in the third lead. Deviation of the heart axis to the left. |
| Posterior branch of the left leg | An R wave is noted in the first, and a Q wave in the third. Deviation of the heart axis to the right. |
| Anterior and posterior branch | The axis of the heart is horizontal. In some cases, it may deviate to the left. A wide R wave is recorded in the first lead. |
| PN + anterior branch | |
| PN + posterior branch | A combination of the above symptoms is noted. Deviation of the heart axis to the right. |
| Three-bundle blockade | The ECG shows the atrioventricular type of block. |
If, during a regular ECG, the blockade of the legs cannot be detected, but the doctor suspects this particular pathology, Holter monitoring is prescribed. During this examination, the patient wears a compact ECG device throughout the day, which records all attacks of cardiac conduction disturbances. With this type of ECG, incomplete blocks of the right bundle branch are detected.
In order to treat blockade of the right and left bundle branches, in addition to treating the underlying disease, the doctor prescribes the following therapy:
You need to understand that to completely get rid of the problem, it is extremely important to treat the underlying disease. That is why it is so important to contact a specialist in a timely manner, as well as follow all his recommendations.
In especially severe cases, it may be prescribed surgical treatment. If drug therapy does not give the desired effect, and the patient complains of frequent fainting and the disease seriously threatens his life, an electrical stimulator is installed. The device generates the correct rhythm and allows the heart to work normally.
If an electrical stimulator has been installed, the patient must follow some recommendations:
Serious damage may be caused by exposure to electric current. Installing a pacemaker is an extremely serious method, which is used only in the most severe cases. To avoid this, it is recommended to undergo timely preventive examinations, as well as correctly treating the underlying disease.
Complete blockade of the right bundle branch is not always a direct indication for installing a stimulator. Typically, this method of therapy is resorted to if atrioventricular block occurs.
If there is a leg block without clinical manifestations, the prognosis of the disease can be confidently called favorable. In this case, the disease does not require specific therapy. The main thing is to prevent the underlying disease from worsening and undergo timely preventive examinations with a doctor.
Even an incomplete block of the His bundle in the right bundle is easily detected during examination. This is why it is so important to visit a specialist and, if necessary, undergo therapy.
Incomplete blockade of the right bundle branch is a fairly common problem. It can be detected during electrocardiography. The problem arises under the influence of congenital or acquired pathologies and requires timely diagnosis. This will prevent the condition from getting worse.
The contraction of the heart muscles is ensured by the conduction system. It contains the sinus and atrioventricular nodes, the His bundle and Purkinje fibers.
The bundle of His consists of a right and left bundle. They ensure the movement of electrical signals to the tissues of the ventricles. If a blockade is diagnosed, this indicates that signals do not pass through it completely or do not arrive at all.
In this case, excitation normally passes only along the left leg, which contributes to the depolarization of the ventricles.
If a partial blockade develops, the electrical signal is not transmitted along one leg. This condition does not pose a threat to the patient's life. The conductivity of the heart slows down in this situation. Similar processes can be detected in people who do not have health problems. Therefore, the problem is often considered as a variant of the norm.
A great danger is the disruption of impulse transmission along the left leg, as this contributes to heart failure.
The pathology is most often diagnosed in men. Older women are more likely to suffer from left leg block.
Often the conduction of impulses slows down in childhood. If pathologies of the heart, respiratory and circulatory systems are absent, then this condition does not pose a danger.
Although the disease most often occurs without the slightest manifestations, it gradually disrupts the functioning of the ventricles.
Incomplete blockade of the right leg can occur under the influence of many diseases. Most scientists are inclined to think that such disorders are not associated with hereditary predisposition. Although if there are pathologies of the heart and blood vessels in close relatives, the likelihood of their development increases significantly.
Conduction disturbances along the right leg occur in different cases:
The electrical impulse is transmitted more slowly than it should if the person has taken large doses.
Incomplete blockade of the right leg of His occurs if the vagus nerve is in an overexcited state. This happens if a person is exposed to excessive physical activity.
Blockades also develop if surgical treatment of heart disease has been performed.
Most often, when the electrical signal does not travel completely down the right leg, the person does not notice any symptoms. Problems are identified during routine electrocardiography.
Patients may experience signs of an underlying pathology that has disrupted cardiac conduction. In this case:
Therefore, treatment of such diseases should be carried out in a timely manner.
But, if the signal is completely blocked:
If such violations occur, you should be promptly examined, as this can occur with dangerous chronic diseases.
Although with incomplete blockade, healthy people do not need specific therapy, since this state considered quite normal.
If you don't diagnostic procedures, then a suitable treatment option cannot be selected. Complete or even partial disruption of the electrical signal leads to a decrease in the number of ventricular contractions. To confirm such changes, electrocardiography is performed and the blood is examined for hormones.
Incomplete blockade of the right bundle branch on the ECG is manifested by a slow passage of the electrical signal. In this case, there is a wave showing contraction of the atria, but there is no wave characteristic of contraction of the ventricle. This disorder is characterized by the appearance of small notches on the S wave and changes appear on the right.
If a person suffers from partial obstruction, then the QRS complex has a normal duration, but sometimes reaches 1.1 seconds.
To identify pathological conditions that can disrupt the progression of the impulse, the patient must additionally undergo procedures in the form of:
Complete blockade of the right leg of the heart is a rare pathological process in the human body. It is not a separate disease, but becomes auxiliary symptom, which is detected during electrocardiography. Although the symptom poses a health hazard, there are no complaints from the patient about feeling unwell.
Most often, the blockade is provoked by infectious diseases suffered in childhood. Among them are:
During the examination of the patient, the doctor identifies residual manifestations of disturbances in the activity of the heart muscle that were not diagnosed in time. However, these myocardial changes that appear in childhood no longer require treatment in adulthood.
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On the other hand, it is very important to diagnose pathological changes in the functioning of the heart muscle in childhood to avoid complications during adult life. Therefore, pediatricians are required to be attentive to patients and take heart problems seriously.
Every organ in the human body requires oxygen, which it receives from the blood, to function properly. Blood circulation is maintained due to the ability of the heart to contract autonomously in a strictly defined rhythm.
Nerve impulses that cause the muscle fibers of the heart to contract are transmitted through the conduction system in the organ. One of the important sections along its length is the His bundle. This element is located in the thickness of the muscular septum, which is located between the left and right ventricles.
The bundle of His has a special structure in which two legs are distinguished - left and right. Nerve impulses pass through them, rushing into one of the heart ventricles. If the nerve conduction of the impulse is disrupted, they speak of a pathology that doctors call bundle branch block.
This pathology is expressed stronger or weaker in different cases. Incomplete heart block is characterized by partial difficulty in the passage of the exciting impulse; complete block is diagnosed when the impulse stops passing through the structures of the legs of the heart.
Depending on the location of the disorder, blockade of one leg is distinguished - right or left, or both at the same time. Very often in childhood blockages form for no apparent reason.
In most cases, such a blockade is incomplete and is in no way associated with any diseases. The pathological process develops asymptomatically. In addition, sometimes it can even be considered a variant of the norm.
If the right leg of the heart is completely blocked, then in this case the nerve impulse is conducted along individual muscle fibers, starting from the left ventricle and the left part of the septum between the ventricles.
Incomplete block of the right leg of the heart of the isolated type is in no way associated with current disorders of internal organs and diseases. In this regard, the pathology proceeds without pronounced signs and therefore difficult to diagnose. Violations are most often discovered accidentally during a routine inspection.
When the right leg of the heart is completely blocked, there are signs of primary diseases against which this disorder develops, including:
However, the blockade itself is also asymptomatic in this case, and is diagnosed exclusively by ultrasound of the chest or during an ECG or listening.
Complete blockage of the left bundle branch can be identified by other symptoms, including:
A characteristic feature of the blockade is that it is not permanent, so it can occur suddenly, but often disappears over time. For example, in the tachycaemic form of the disease, the disorder is eliminated when the heart rate normalizes.
With a three-bundle blockade, complete or incomplete isolation along the path of passage is also formed nerve impulse. With incomplete blockade, impulses conducted to the ventricles along intact fibers are blocked.
With a complete three-fascicle blockade, the impulses do not pass through at all. In this case, an ectopic focus of excitation appears in the cardiac ventricles. The work of the atria and ventricles is completely disconnected, and the heart rate per minute slows down to 20-40. This indicator is significantly lower than normal, which indicates that a full ejection of blood into the aorta is impossible.
This type of blockade is accompanied by fainting caused by difficulty in blood circulation in the brain and concomitant oxygen starvation of the organ. There may also be sensations of disruption in the functioning of the heart and dizziness. In such cases, the risk of sudden death increases.
The prognosis for cure worsens in the presence of arterial hypertension or ischemia. However, acute infarction most often does not have a significant effect on the development of blockade. The likelihood of death increases in the presence of a large transmural infarction.
An unfavorable prognosis for complete blockade is given if myocardial infarction is present. In this case, 40-50 patients out of 100 die. Also, low chances of cure are observed with a three-bundle block, since this increases the risk of asystole.
The causes of blockade of the right leg of the heart are usually multiple congenital anomalies:
Complete blockade of the right bundle branch is formed due to certain diseases. Their list is quite extensive:
There is no bundle branch block specific signs, and disorders are usually diagnosed incidentally during routine examinations. In this regard, it is possible to identify violations only by the presence concomitant diseases hearts. Accordingly, treatment for blockage of the right leg of the heart begins with eliminating negative influence of these diseases on the body.
There are 4 main diseases against which a blockage in the His bundle develops:
Before directly eliminating the consequences that arise due to blockage of the bundle branch, it is necessary to treat primary disease, which provoked the development of pathology.
The very fact of the presence of blockage of the legs of the heart indicates the presence of significant disorders in the organ. They are localized in the muscles of the right ventricle or in the septum between the ventricles.
| Medicines | Certain medications are used to treat the effects of right bundle branch block, including the following:
The specific type of drug is selected by the doctor in each case individually, taking into account the indicators obtained from the research results. As part of additional therapy, the patient is prescribed medicines from arrhythmia. If there is a persistent increase blood pressure, the doctor prescribes medications to the patient to eliminate this symptom. |
| Surgery | Surgical intervention may be required if the blockage of the heart pedicle was caused by some congenital heart defect. |
Upon completion of the full course of treatment or after surgery, the patient should continue to be monitored by general practitioners and cardiologists. Specialists will monitor all changes. If such a need arises, they will adjust the treatment methods in time.
However, everything negative consequences in most cases, they develop due to the fact that the patient ignores the doctor’s recommendations. Therefore, in order to save yourself from various risks, it is necessary to undergo a medical examination in a timely manner and appear for an examination with your doctor.
It is especially important to consult a doctor for those patients who are currently being treated cardiovascular system. When the first dangerous symptoms It is important to go to the hospital immediately, without delaying the examination until later. The consequences may be irreversible.
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10.4. Intraventricular conduction disorders
10.4.1. Right bundle branch block (RBBB)
Right bundle branch block (RBBB) occurs in 0.1-0.2% of cases in young people. With age, its frequency increases, reaching 0.3-0.24-4.5% in people over 40 years of age. RBBB occurs more often in men.
In acute myocardial infarction, RBBB appears in 2-3.7% of cases and mainly in anterior infarction, more often in transmural ones. Partial RBBB also occurs with posterior myocardial infarction.
Etiology. In young people, blockade of the right bundle branch is often (21-50% of cases) benign and not associated with cardiac pathology. In other cases, especially in older people,
RBBB is caused by hypertension (60% of cases), ischemic heart disease (although it more often causes blockade of the left bundle branch). Less commonly, RBBB may be caused by congenital anomaly- underdevelopment of the initial segment of the right bundle branch; birth defects heart (atrial septal defect, less often interventricular septal defect, stenosis of the orifice pulmonary artery); stretching of the right ventricle due to pulmonary embolism or obstructive chronic diseases lungs (then more often there is a partial blockade of the right bundle branch); Lev and Lenegre diseases; acute myocardial infarction; cardiomyopathy; blunt chest trauma; hyperkalemia, progressive muscular dystrophy; overdose of novocainamide, quinidine, less often cardiac glycosides; neoplasms of the heart; surgical operations on the heart, for example vertical ventriculotomy; syphilitic gumma.
May be detected clinical signs organic disease causing RBBB. In addition, in 1/3 patients, some changes are detected during auscultation: splitting of the second tone, which occurs more often, and splitting of the first tone, which occurs less frequently (due to asynchronous reduction ventricles).
Diagnostic ECG criteria. Complete RBBB: duration of complex #R5>0.12 s; a high wave R or R' in lead Vi, sometimes in V2, 3 (a small p is usually recorded before the R wave. In lead aVR there is often a deep Q wave and a wide, jagged R wave. In I and left chest leads usually a variable size R wave and a wide, jagged S wave are detected); ST and T are deviated discordantly from the main direction of the QRS complex. When the electrical axis deviates to the left, the rR jagged R or qR shapes are recorded in lead Vj. When the electrical axis deviates to the right, a qR shape is observed in lead V1.
Partial RBBB: The morphology of the QRS complex is identical to complete RBBB, but its duration is 0.11 seconds. As the degree of blockade increases, the duration of the QRS complex increases and the R' deflexion in lead Vi becomes higher. More often (in 87% of cases) RBBB is constant, less often it is intermittent.
right bundle branch block in special treatment doesn't need it. The appearance of RBBB in the acute period of myocardial infarction does not require preventive epdocardial stimulation.
requires. If necessary, treat the underlying disease that caused RBBB.
Prognosis: Young people without organic heart disease have a relatively favorable prognosis. Most authors believe that isolated RBBB never turns into complete AV block, and even the joint finding of first degree atrioventricular block has no prognostic value, since EFI in such cases, as a rule, only finds an extension interval A-H, indicating deterioration of AV conduction in the AV connection. However, some authors point to the rare (1.8-6%) progression of RBBB to 2nd or 3rd degree AV block.
Associated RBBB on the background of hypertopic disease or ischemic heart disease worsens the prognosis, increasing mortality by almost 3 times. The prognosis is worsened by cardiomegaly, heart failure, prolongation H-V interval. The prognosis for RBBB is always better than for left bundle branch block.
In the background acute heart attack myocardium, the resulting complete or partial BPIP does not, according to our data [Reingardene D. 1975], turn into complete AV block and does not worsen the outcome of the disease. Some authors [Doshchitsin V. L. 1979, etc.] with RBBB note an increase in mortality, but only with extensive transmural myocardial infarction with heart failure. RBBB does not affect the long-term prognosis of infarction, although there is an opposite opinion.
Blockade of this level refers to disturbances at the level of conduction inside the ventricle of the heart, that is, it is an intraventricular block. Sometimes this can be found in apparently healthy young people, which should be considered as an option physiological norm. Considering that the blockade of one of their legs reflects a conduction disorder, it is necessary to examine the patient in order to identify the disease that led to the development of the disorder.
As a rule, the blockade develops against the background of heart disease. Conduction disorders inside the ventricle of the heart are often caused by necrotic, sclerotic, inflammatory processes. In addition, the cause may be those pathological processes that lead to a state of overload of some parts, in particular the ventricle. Such diseases include heart defects (congenital, in which there is an excessive load on the right ventricle, defects of the septa between the atria and ventricles), mitral stenosis, coronary artery disease, heart disease, acute conditions(heart attack), arterial hypertension and cardiosclerosis.
The causative factors for the development of an incomplete type of blockade are intoxication or overdose medicines(from the group of digitalis, adrenergic blockers), disturbances in electrolyte metabolism. Due to the development of the blockade, the conduction of impulses through the heart system slows down, which leads to the fact that physiological, full excitation of the right sections does not occur. The diagnosis of blockade separately at the level of the right leg can only be established on the basis of an electrocardiographic study. At ECG decoding changes in the QRS complex are detected (expansion and jaggedness of its terminal part), while the duration of the complex itself is usually increased. In the chest leads, the R wave will be enlarged and jagged, the ST segment will be lowered.
Therapeutic measures for incomplete blockade consist in treating the disease that is the cause of the blockade. That is, there is no specific therapy for the blockade itself; it is necessary to treat the underlying disease. For example, birth defects in modern conditions can be operated on in a cardiac surgery clinic (if there are appropriate indications for this). If the patient suffers from heart failure, angina pectoris, hypertension, therapy is carried out with cardiac glycosides, antiarrhythmics, and antihypertensive drugs.
In some young people, this type of blockade is normal, so therapy is not prescribed. We can only recommend dynamic observation and examination by a cardiologist.
Depending on the identified underlying disease, the patient needs observation and treatment from a cardiologist or therapist. Observation involves assessing the dynamics of changes in the ECG and adjusting prescribed therapy based on clinical and laboratory examination.
Often in the electrocardiographic report you can find the term “bundle branch block”. The blockade can be complete or incomplete, affecting the right or left legs, or branches of the left leg. Let's figure out what it is.
The electrical impulse that excites the heart comes from sinus node through the atria into the atrioventricular node, which lies between the atria and ventricles. A pathway called the “bundle of His” begins from the atrioventricular node. This bundle splits into two smaller trunks - the right and left legs, which conduct excitation to the right and left ventricles. The left leg then divides into anterior and posterior branches. These branches further break up into many small branches that conduct electrical impulses to the muscle fibers of the heart.
For various physiological and pathological conditions conduction along these paths is disrupted. Blockades of the bundle branches and their branches occur.
The blockade can be complete or incomplete. With incomplete blockade, conduction along the leg slows down. With a complete blockade, excitation occurs in an unusual way, “bypassing” the site of the blockade.
Sometimes blockades of two or three of the listed branches appear at once. They are called “two-beam” and “three-beam”, respectively, and arise when serious illnesses hearts.
Incomplete blockade of the right bundle branch can be recorded in healthy young people and is not a deviation from the norm. 
Incomplete blockades of the legs may appear with an increase in heart rate, which in some cases may be regarded by the doctor as a pathological sign.
Bundle branch blocks, both complete and incomplete, can be a sign of heart disease, in particular myocardial dystrophy, angina pectoris. myocardial infarction and scar changes after it, diffuse cardiosclerosis. hypertension, heart defects and others. Any pathological process in the heart muscle can also affect the conduction system, resulting in the development of this electrocardiographic sign.
Complete blockade of the right bundle branch is most often a sign of enlargement of the right ventricle with some heart defects, as well as with the formation of chronic pulmonary heart disease, so it is often found in chronic obstructive pulmonary disease, emphysema, and severe bronchial asthma.
Complete blockade of the left bundle branch most often appears against the background of coronary heart disease (angina pectoris, cicatricial changes after myocardial infarction). In this case, it is associated with a poorer prognosis for such patients, as it reflects severe damage to the heart muscle.
These electrocardiographic signs are not clinically apparent.
DiagnosticsThe main diagnostic method is electrocardiography. Signs temporary blockade can be seen during daily (Holter) electrocardiogram monitoring.
Prognosis, ability to work, ability to perform physical activity determined by the severity of the underlying disease.
Block of the bundle branches is a failure of conduction in the heart; it is characterized by inhibition or complete blocking of the transmission of impulse excitations in one or several branches of the His bundle in the heart muscle. Such a deviation can be asymptomatic. Diagnosed when medical examination patient, sometimes reveals itself with the following signs: irregular heartbeat, dizziness, and sometimes loss of consciousness. Diagnosis of the disease occurs using electrocardiography. Therapeutic measures are aimed at eliminating the factors that provoke the disease; often there is a need to install an artificial heart rate regulator.
U healthy person The heart rhythm is sinus, thanks to it the conduction of impulses is carried out, which contributes to the contractile action of the myocardium.
The line of the anterosuperior pedicle runs along the interventricular wall, in the middle it is divided into three branches: the anterior, median and posterior branches.
The impulse originates in the right atrium, from which it passes to the atrioventricular zone, where atrial excitation is formed, then through the left leg it passes to the left ventricular region. This is where deviations in the organization of the impulse and its permeability appear.
What are bundles of His, is it dangerous?With blockade of the left bundle branch (LBB), absolute or partial inhibition of the impulse is observed. The diagnosis is based on an electrocardiogram.
Important! This is not a separate pathology, it develops with other diseases of the heart and blood vessels, therefore, during treatment, the main therapeutic measures should be concentrated on curing the underlying pathology.
The risk of pathology increases in older people, more so in men, but this does not mean that children are not susceptible to such abnormalities.
Formation of excitation Blockades are divided into complete and partial, with a damaging effect on one or two knives. Complete blockade of the left bundle branch is characterized by the final stop of impulse transmission. Partial is manifested by a delay. In stage 1, the impulses penetrate longer than usual; in the second, some of the impulses stop, that is, they pass only partially. These stages are considered to be incomplete blockade of the left bundle branch. Complete blockade is characterized by independent ventricular contraction, which entails a decrease in heart contractions: their maximum quantity does not exceed 40 beats per minute, but 60-80 is necessary.
Left bundle branch block The following reasons have been identified that contribute to the formation of the disease:
Cardiogram In children, left bundle branch block can develop due to heart defects : accessory ventricular chord, left valve prolapse and others.
There are no definite signs of blockade, but there are some discrepancies on the cardiogram.
On the ECG, complete blockade of the left bundle branch is determined by discrepancies, when the cardiac axis shifts to the left, the function of the leg is not observed. A similar phenomenon can develop after a heart attack and significant deviations in the left ventricular zone. There are complaints of pain, increased heartbeat, malaise, and lightheadedness.
Blockade of the anterior branch of the left bundle branch (abbreviated as LBB) with ECG is determined by the following indicators:
There are no characteristic signs, but they can manifest themselves as symptoms of a key disease.
Blockade of the posterior branch of the left bundle branch is determined by the same deviations, only the QRS deviates from the norm to the side.
Regardless of which side of the fork is affected, ECG signs certain deviations are considered. Chest pain and shortness of breath are possible.
With incomplete blockade of the left bundle branch, excitation is passed along the minimally damaged branch, as a result of which a 1st or 2nd degree atrioventricular block begins to form. When complete, impulses cannot pass, so the formation of a 3rd degree blockade is observed, atrial fibrillation.
As the number of strokes decreases, the body suffers from oxygen starvation, which manifests itself severe dizziness, frequent fainting, heart rhythm disturbances. Cardiac arrest often occurs and death occurs - this is what makes the disease dangerous.
At the appointment, the therapist detects irregularities in the number of contractions, which becomes the reason for a thorough examination of the patient. An ECG for left bundle branch block is the main diagnostic method, and conclusions are drawn based on the data obtained.
Blockage in the anterior branch Attention! When studying test results, we must not forget that both disorders are accompanied by myocardial infarction or heart failure.
After studying the electrocardiogram data, the patient is sent for tests so that the diagnosis can be made reliably:
The last two analyzes make it possible to determine the balance of electrolytes, hormonal levels, the presence of autoimmune reactions.
To determine concomitant diseases, the following diagnostic measures are carried out:
To diagnose pathology in a child, the same methods are used as in adults.
Incomplete left bundle branch block usually does not require treatment. More often, such a disorder does not have serious causes and does not progress to advanced stages, therefore it is not dangerous for humans. Only occasionally when high blood pressure capable of progressing to the 2nd or 3rd degree, in such situations the specialist prescribes to the patient drug treatment for preventive purposes.
Approximately the same thing happens when observing more serious blockades. The doctor determines complex therapy. Primary treatment is aimed at the underlying pathology, which became the provocateur of this phenomenon. The following measures are most often prescribed:
Therapy is prescribed by the attending physician based on each individual case. Often needed surgical methods treatment. Such therapy is necessary for two-, three-bundle blockades and complete one of the branches. Installation of pacemakers (permanent or temporary) is common. Sometimes the doctor considers it rational to perform radiofrequency catheter ablation - a minimally invasive technique with the introduction of a catheter. It is possible to install a cardioverter-defibrillator, which causes the heart muscle to contract.
Incomplete blockade Most often, during blockades a person can live everyday life, but it is necessary to eliminate physical and emotional stress. Doctors recommend exercising therapeutic exercises, relax and walk on fresh air. Provide healthy eating, use unsalted and low-fat food, refrain from bad habits, and nicotine is more harmful.
Important! After installing a pacemaker, you must visit a specialist first after 3 months, then after 6 months, and if there are no problems - once a year.
With a partial blockade and the absence of serious violations, dangerous consequences do not arise, especially if the patient follows all the specialist’s recommendations. The prognosis in such cases is favorable.
