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Is there an entity called Ischemic RBBB ?

Posted Apr 11 2014 12:00am

A 76 year old man with history of recent stroke presented with acute chest pain  and his ECG  showed ,

ischemic rbbb

It was diagnosed as Anterior STEMI .Since he had co-exciting renal dysfunction also he was not considered for thrombolysis (Primary PCI not feasible !)

IV  Heparin bolus followed by infusion was started. Patient  had a comfortable night stay. The ECG taken on the morning  looked like this.

 

Transient RBBB due to Ischemia in  LAD territory(with septal compromise ) is very much possible during ACS. But , it is a rarely discussed entity unlike ischemic LBBB .

We know qRBBB  complicating anterior STEMI is much commoner than LBBB , still transient ischemic RBBB in non STEMI setting seems to be uncommon .Is it possible propensity for  Ischemic RBBB is different from necrotic RBBB ?

 

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