Cardiovascular Medicine Book

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Bundle Branch BlockAka: Left Bundle Branch Block, Right Bundle Branch Block, Left Anterior Hemiblock, Left Posterior Hemiblock

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  1. Findings: Left Bundle Branch Block EKG
    1. Lead V1
      1. QS or rS
    2. Lead V6
      1. Late intrinsicoid deflection
      2. No Q wave
      3. Monophasic R Wave
    3. Lead I
      1. Monophasic R Wave
      2. No Q wave
  2. Findings: Right Bundle Branch Block EKG
    1. Lead V1
      1. Late Intrinsicoid Deflection
      2. M-shaped QRS Complex
      3. Wide R Wave or qR (occasionally)
    2. Lead V6
      1. Early Intrinsicoid Deflection
      2. Wide S wave
    3. Lead I
      1. Wide S wave
  3. Findings: Left Anterior Hemiblock EKG
    1. Left Axis Deviation (beyond -60 degrees)
    2. Small Q wave in Lead I
    3. Small R Wave in Lead III
    4. Normal QRS Duration
    5. No Right Ventricular Hypertrophy
  4. Findings: Left Posterior Hemiblock EKG
    1. Right Axis Deviation (beyond +120 degrees)
    2. Small R Wave in Lead I
    3. Small Q wave in Lead III
    4. Normal QRS Duration
    5. No Right Ventricular Hypertrophy

Bundle-Branch Block (C0006384)

Definition (MSH)A form of heart block in which the electrical stimulation of HEART VENTRICLES is interrupted at either one of the branches of BUNDLE OF HIS thus preventing the simultaneous depolarization of the two ventricles.
ConceptsPathologic Function (T046)
ICD9426.50
MSHD002037
EnglishBBB - Bundle branch block, BLOCK BUNDLE BRANCH, Bundle Branch Block, Bundle branch block unspecified, Bundle-branch block, Bundle-Branch Blocks, HEART BLOCK BUNDLE BRANCH
Spanishbloqueo de rama, bloqueo de rama del haz de His, bloqueo de rama no especificado
Parent ConceptsConduction disorder of the heart (C0264886), cardiac arrhythmia (C0003811), Abnormal cardiac conduction (C0232219), Bundle branch block, other and unspecified (C0677586), Heart Block (C0018794), Intraventricular conduction defect (C0264909), Other bundle branch block NOS (C0340501), Duplicate concept (C1274013)
SourcesCCS, COSTAR, CSP, CST, ICD9CM, LCH, MSH, MTH, NDFRT, OMIM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


Left Bundle-Branch Block (C0023211)

Definition (NCI)An impairment of transmission of the cardiac electrical impulse along the fibers of the left main bundle branch, or both the left anterior fascicle and left posterior fascicle. This conduction disturbance is characterized by wide (greater than 0.11s) QRS complexes. The diagnostic criteria consist of prolongation of the QRS complexes (over 0.11s) with neither a Q wave nor an S wave in lead V1 and in the "properly placed" V6. A wide R wave with a notch on its top ("plateau") is seen in these leads. In hearts with an electrical (and anatomic) vertical position a small Q wave may be seen in AVL in the absence of MI. Right chest lead V1 may or may not show an initial R wave, but the latter should be present in lead V2.
ConceptsDisease or Syndrome (T047)
ICD9426.3
MSHD002037
EnglishLBBB, LBBB - Left bundle branch block, Left bundle branch block, Left Bundle-Branch Block, Left Bundle-Branch Blocks
Spanishbloqueo de la rama izquierda del haz de His
Parent ConceptsHeart Block (C0018794), Bundle-Branch Block (C0006384), Ventricular arrhythmia (C0085612), Duplicate concept (C1274013)
SourcesCOSTAR, DXP, MSH, MTHICD9, NCI, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


Right Bundle-Branch Block (C0085615)

Definition (NCI)An impairment of transmission of the cardiac electrical impulse along the fibers of the right bundle branch. A " complete RBBB pattern" (with QRS duration > 0.11s) does not necessarily reflect the existence of a total conduction block in the right branch. This pattern only indicates that the entire or major parts of both ventricles are activated by the impulse emerging from the left branch. Thus, a significant degree of conduction delay ("high-grade" or "incomplete RBBB) can produce a similar pattern.
ConceptsDisease or Syndrome (T047)
ICD9426.4
MSHD002037
EnglishRBBB, RBBB - Right bundle branch block, Right bundle branch block, Right Bundle-Branch Block, Right Bundle-Branch Blocks, Right fascicular block, RT BUNDLE BRANCH BLOCK
Spanishbloqueo de la rama derecha del haz de His, hemibloqueo ventricular derecho
Parent ConceptsConduction disorder of the heart (C0264886), Heart Block (C0018794), Bundle-Branch Block (C0006384), Ventricular arrhythmia (C0085612), Duplicate concept (C1274013)
SourcesCOSTAR, DXP, ICD9CM, MSH, NCI, OMIM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


Left anterior fascicular block (C0264912)

Definition (NCI)An impairment of transmission of the cardiac electrical impulse along the fibers of the left anterior fascicle. In left anterior fascicular block (LAFB) the posteroinferior regions of the left ventricular endocardium are activated abnormally before the anterosuperior left ventricular area. After emerging from the posteroinferior division of the left bundle branch, the impulse first propagates in an inferior, rightward, and usually anterior direction for a short period of time. This orientation is responsible for the small q waves in leads I and aVL and for the r waves in leads II, III, and aVF.
ConceptsPathologic Function (T046)
ICD9426.2
EnglishLAFB, LAFB - Left anterior fascicular block, Left Anterior Fascicular Block, Left Anterior Hemiblock
Spanishbloqueo de la rama izquierda anterior del haz de His, bloqueo fascicular izquierdo anterior, hemibloqueo anterior izquierdo
Parent ConceptsHeart Block (C0018794), Left Bundle-Branch Block (C0023211), Monofascicular block (C0264911)
SourcesMTH, MTHICD9, NCI, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


Left posterior fascicular block (C0264913)

Definition (NCI)An impairment of transmission of the cardiac electrical impulse along the fibers of the left posterior fascicle. In pure left posterior fascicular block (LPFB), the impulse emerges from the unblocked anterosuperior division, thus producing small q waves in leads II, III, and aVF. Thereafter, the impulse moves through the electrically predominant left ventricle in an inferior and rightward direction, thus explaining the S waves in leads I and aVL as well as the R waves in leads II, III, and aVF.
ConceptsPathologic Function (T046)
ICD9426.2
EnglishLeft Posterior Fascicular Block, Left Posterior Hemiblock, LPFB
Spanishbloqueo de la rama izquierda posterior del haz de His, bloqueo fascicular izquierdo posterior, hemibloqueo posterior izquierdo
Parent ConceptsHeart Block (C0018794), Left Bundle-Branch Block (C0023211), Monofascicular block (C0264911)
SourcesMTHICD9, NCI, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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