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Related Experiment Videos

[Intermittent complete left bundle branch block during general anesthesia].

Akihiko Nonaka1, Satomi Suzuki, Taishi Masamune

  • 1Department of Anesthesia, Yamanashi Prefectural Central Hospital, Yamanashi 400-0027.

Masui. the Japanese Journal of Anesthesiology
|February 3, 2005
PubMed
Summary

This case study highlights intermittent complete left bundle branch block (CLBBB) during anesthesia. Esmolol effectively distinguished this benign condition from myocardial ischemia in an 83-year-old patient.

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Area of Science:

  • Cardiology
  • Anesthesiology

Background:

  • Preoperative ECG revealed atrial fibrillation and ST depression in V4-6.
  • An 83-year-old female underwent right lung upper lobectomy under general anesthesia.

Observation:

  • Intermittent complete left bundle branch block (CLBBB) appeared on ECG after surgery upon repositioning.
  • The CLBBB was diagnosed as rate-dependent, occurring at a heart rate of 92 bpm.

Findings:

  • Administration of esmolol hydrochloride rapidly decreased heart rate and normalized ECG conduction.
  • The patient remained asymptomatic with normal cardiac enzymes, despite persistent CLBBB until the next day.

Implications:

  • Intermittent CLBBB during anesthesia can complicate the diagnosis of myocardial ischemia or infarction.

Related Experiment Videos

  • Esmolol may serve as a safe and effective tool to differentiate benign CLBBB from acute coronary events.