Painful left bundle branch block syndrome: A case report
1Department of Cardiology, Jing'an District Central Hospital, Shanghai, China; Department of General Practice, Caojiadu Street Community Health Center, Shanghai, China.
Journal of Electrocardiology
|July 30, 2025
Summary
This case report details a rare painful left bundle branch block (LBBB) syndrome in a 74-year-old woman presenting with angina. Despite symptoms, no obstructive coronary artery disease was found, indicating complex LBBB pathophysiology.
Area of Science:
- Cardiology
- Electrophysiology
- Internal Medicine
Background:
- Painful left bundle branch block (LBBB) syndrome is rare and challenging to diagnose.
- LBBB can present with diverse symptoms, including angina pectoris.
- The underlying pathophysiology of symptomatic LBBB without coronary artery disease is not fully understood.
Purpose of the Study:
- To report a unique case of painful LBBB syndrome.
- To illustrate the diagnostic challenges in rate-dependent LBBB with angina.
- To highlight the importance of considering non-obstructive causes in LBBB-associated chest pain.
Main Methods:
- Case presentation of a 74-year-old female patient.
- Clinical assessment including electrocardiography for LBBB diagnosis.
- Diagnostic workup to exclude obstructive coronary artery disease.
Main Results:
- The patient presented with classic features of rate-dependent LBBB and angina pectoris.
- Extensive evaluations ruled out obstructive coronary artery disease as the cause of symptoms.
- This case underscores a complex interplay in LBBB syndrome.
Conclusions:
- Symptomatic LBBB, even with angina, can occur without obstructive coronary artery disease.
- This case highlights the diagnostic complexity and potential for underdiagnosis of LBBB syndrome.
- Further research into the pathophysiology of painful LBBB is warranted.
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