A case of 'Masquerading' bundle branch block: a forgotten concept
Dinesh Choudhary1, Narayanan Namboodiri2, Jaganmohan A Tharakan3
1Fellow in Cardiac Electrophysiology, Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram 695 011, India.
Indian Heart Journal
|March 4, 2014
Summary
A rare congenital heart condition caused congestive heart failure and a unique ECG pattern known as masquerading bundle branch block. This case highlights a novel association between intranuclear inclusion myopathy and this specific cardiac presentation.
Area of Science:
- Cardiology
- Genetics
- Pathology
Background:
- Masquerading bundle branch block (MBBB) typically presents as right bundle branch block in precordial leads and left bundle branch block with left axis deviation in frontal leads.
- MBBB is commonly associated with coronary artery disease and hypertension, but its etiology remains unclear.
- Congenital heart conditions can manifest with complex electrocardiographic findings.
Observation:
- This report details a rare case of congenital intranuclear inclusion myopathy.
- The patient presented with congestive heart failure and an ECG showing MBBB.
Findings:
- This case demonstrates an unusual association between congenital intranuclear inclusion myopathy and MBBB.
- The findings suggest a potential link between this rare genetic disorder and cardiac electrical abnormalities.
Implications:
- This case expands the known clinical spectrum of congenital intranuclear inclusion myopathy.
- Further research may elucidate the mechanisms underlying MBBB in genetic myopathies and its implications for cardiovascular risk stratification.
Related Concept Videos
01:18Dysrhythmias IV: Characteristics of Bradyarrhythmias
788
Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...
788
01:25ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
1.2K
Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
1.2K
01:25Dysrhythmias VI: Management of Dysrhythmias
597
Dysrhythmia management involves a multifaceted approach, incorporating pharmacological treatments, medical procedures, surgical interventions, lifestyle modifications, and patient education.Pharmacological ManagementAntiarrhythmic Drugs:Class I (Sodium Channel Blockers): This class includes quinidine and procainamide, which reduce the speed of impulse conduction in the heart, stabilize the cardiac membrane, and control arrhythmias. Quinidine and procainamide are Class IA agents that prolong the...
597
01:20Mitral Regurgitation I: Introduction
1.3K
Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
1.3K
01:29Disturbances in Heart Rhythm
5.3K
Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
5.3K
01:15Aortic Regurgitation I: Introduction
1.6K
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
1.6K