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Different ECG manifestations of left ventricular hypertrophy in presence of intermittent LBBB and RBBB

Anna E Platek1, Grzegorz Karpinski1, Filip M Szymanski1

  • 11st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.

Journal of Electrocardiology
|May 11, 2015
PubMed

Insights

This case study shows how left ventricular hypertrophy (LVH) and bundle branch blocks (LBBB/RBBB) alter electrocardiogram (ECG) QRS complex morphology in patients with aortic stenosis.

Area of Science:

  • Cardiology
  • Electrocardiography
  • Cardiac Electrophysiology

Background:

  • Aortic stenosis is a common valvular heart disease requiring invasive correction.
  • Left ventricular hypertrophy (LVH) and bundle branch blocks (LBBB, RBBB) are frequent comorbidities.
  • Electrocardiography (ECG) is crucial for diagnosing and monitoring cardiac conditions.

Observation:

  • An 86-year-old female with aortic stenosis presented with severe LVH and intermittent LBBB and RBBB.
  • A single ECG examination revealed specific changes indicative of LVH across all intraventricular conduction patterns.
  • The study observed the impact of bundle branch blocks on intracardiac depolarization vectors.

Findings:

  • Bundle branch blocks significantly alter the QRS complex morphology on ECG.
  • LVH-specific ECG changes can be present despite the presence of LBBB or RBBB.
  • Intracardiac vector changes due to conduction abnormalities influence ECG waveform.

Implications:

  • Understanding these ECG alterations is vital for accurate diagnosis in complex cardiac cases.
  • This case highlights the importance of considering conduction abnormalities when interpreting ECGs for LVH.
  • The findings contribute to the understanding of electrophysiological changes in valvular heart disease and conduction system disease.

Keywords:
ECGLBBBLeft ventricular hypertrophyRBBB

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