Wednesday, January 19, 2011

RBBB in MRCP

RBBB in MRCP

OK, Right bundle branch block ( RBBB) is certainly a favourite ECG finding your consultant would like to show you during grand round.

How to pick up RBBB? It is easy, always look for rsR pattern in lead V1 with prolonged QRS complex ( it can be normal in partial RBBB). Besides that, pick up the slurred S ( wide negative S) wave in V6.

Common question for MRCP exam, the causes for RBBB, just remember a few important causes below,
1) Normal variant
2) Increased  right ventricular pressure,especially in cor pulmonale and sometimes in pulmonary embolism.
3) Congenital heart disease especially atrial septal defect
4) Myocardium ischemia, myocarditis etc.

However, you must not miss Brugada syndrome which has quite similar ECG finding such as RBBB as showed below,

The right bundle branch block pattern seen in patients with this syndrome is not actually right bundle branch block but is a function of the unusual repolarization abnormality. The ECG shows ST-segment elevation in leads V1-V3, and patients are at risk for sudden cardiac death.

2 comments:

Anonymous said...

RBBB is the Right bundle branch block patterns with a normal duration of QRS complex. Generally there is no indication to suggest recognized RBBB carries other than a normal prognosis. Right bundle branch block may indicate pathology in the right side of the heart. Right bundle branch block may arise in other pathologies.
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Coin Master Free Spins said...

Awesome post about mrcp part 1 qbank .

Thank you