Acute myocardial infarction associated with right bundle branch block and changeable trifascicular block: a case report

Elsayed, Yasser Mohammed Hassanain

doi:10.4103/2221-6189.268412

Cited by 3 publications

(5 citation statements)

References 10 publications

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“…A review of the published literature finds a dearth of articles on how to interpret Electrocardiography (ECG) abnormalities caused by an infarct or an ischemic event when there is a right bundle branch block [1] . It only show about 6% in Myocard Infarction [2] . Meanwhile, European Society of Cardiology latest guideline describing RBBB as a high risk for mortality in patients with suspected myocardial infarction [3] .…”

Section: Introductionmentioning

confidence: 92%

Right Bundle Branch Block Evolves to Ischemic Myocard in Patient with Chronic Back Pain: A Case Report

Ardiana

Sufiyah

2023

Preprint

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Section: Introductionmentioning

confidence: 92%

Right Bundle Branch Block Evolves to Ischemic Myocard in Patient with Chronic Back Pain: A Case Report

Ardiana

Sufiyah

2023

Preprint

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“…A review of the published literature reveals a dearth of articles on how to interpret electrocardiography (ECG) abnormalities caused by an infarct or an ischemic event when there is RBBB [ 1 ]. It only appears in about 6% of cases of myocardial infarction (MI) [ 2 ]. The latest European Society of Cardiology guidelines describe RBBB as a high risk for mortality in patients with suspected MI [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Right bundle branch block evolving to myocardial ischemia in a patient with chronic middle back pain: a case report

2023

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Background A right bundle branch block (RBBB) is rarely found in patients with myocardial infarction (MI). In addition, back pain is an atypical complaint in patients with angina. Case A 77-year-old Javanese male was admitted with middle back pain that he had had for several months but that had become worse in the past week. He received an oral nonsteroidal anti-inflammatory drug as analgesic therapy but the pain did not improve. The patient came to the emergency room and an electrocardiogram (ECG) showed complete RBBB and first-degree atrioventricular block. Three days after hospital admission, his chief complaint of pain had worsened, and ECG showed new deep arrow-head inverted wave at V3–V6, II, III, and aVF, as well as infero-anterolateral ischemia. The coronary angiography revealed 95% critical stenosis in left circumflex artery. Discussion It is a challenge for clinicians to recognize and carefully assess a patient’s complaints even if they are admitted for pain that is “atypical” of MI. When ECG shows changes, clinicians need to pay attention to a tricky, hidden, and life-threatening occlusion of the coronary artery.

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“…The most important causes of trifascicular HB are ischemic artery disease, anterior myocardial infarction (MI), hypertension, CHD, a primary degenerative disease of the conducting system (such as Lenègre–Lev disease), aortic stenosis, digitalis toxicity, and hyperkalemia. 7 , 8 There are 2 types of trifascicular HB: the first is incomplete trifascicular HB, which is characterized by a bifascicular HB with a first-degree HB (MCC), a bifascicular block with a second-degree HB, and RBBB with alternating left anterior fascicular block (LAFB)/left posterior fascicular block (LPFB), while the second is complete trifascicular HB, which is characterized by a bifascicular block with a third-degree HB. 7 , 8 Several new mechanisms have been implicated in cardiac damage due to the coronavirus disease 2019 (COVID-19) epidemic.…”

Section: Introductionmentioning

confidence: 99%

“…7 , 8 There are 2 types of trifascicular HB: the first is incomplete trifascicular HB, which is characterized by a bifascicular HB with a first-degree HB (MCC), a bifascicular block with a second-degree HB, and RBBB with alternating left anterior fascicular block (LAFB)/left posterior fascicular block (LPFB), while the second is complete trifascicular HB, which is characterized by a bifascicular block with a third-degree HB. 7 , 8 Several new mechanisms have been implicated in cardiac damage due to the coronavirus disease 2019 (COVID-19) epidemic. The systemic inflammatory response in severe COVID-19 provokes a high level of cytokines, causing a cytokine release syndrome that can injure multiple tissues and involving the vascular endothelium and cardiac myocytes.…”

Section: Introductionmentioning

confidence: 99%

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Resolution of Trifascicular Heart Block with Effective Closure of Congenital Atrial Septal Defect Followed by Later Coronavirus Disease 2019–associated Cardiac Strain

ELSAYED,

ALMARGHANY

2023

J Innov Cardiac Rhythm Manage.

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Heart block (HB) is one of the most serious arrhythmias. Higher degrees of HB—for example, trifascicular HB—result in a more intense patient condition. Atrial septal defects (ASDs) represent the most common congenital heart disease in adults. All ASDs generally result in a left-to-right shunt, commonly causing right-side enlargement and dilation and, to a lesser extent, left atrial enlargement. A 26-year-old woman presented to the physician outpatient clinic with a complicated ASD with trifascicular HB and severe mitral and tricuspid regurgitations. The trifascicular HB with valvular regurgitations resolved with congenital ASD closure; however, she was diagnosed with coronavirus disease 2019 (COVID-19)–associated cardiac strain 3 years later. Interventions included electrocardiography, oxygenation, echocardiography, and cardiovascular surgical repair. A dramatic electrocardiographic response and better clinical outcomes despite dilations of both atria were observed. Trifascicular HB is a newly recorded association after congenital ASDs in adults. The disappearance of trifascicular HB after surgical closure of the congenital ASD is an indicator of effective surgical repair. The occurrence of COVID-19 pneumonia later, with atrial dilations continuing after the infection, may be a constellation of risk factors for the observed cardiac strain.

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Acute myocardial infarction associated with right bundle branch block and changeable trifascicular block: a case report

Cited by 3 publications

References 10 publications

Right Bundle Branch Block Evolves to Ischemic Myocard in Patient with Chronic Back Pain: A Case Report

Right Bundle Branch Block Evolves to Ischemic Myocard in Patient with Chronic Back Pain: A Case Report

Right bundle branch block evolving to myocardial ischemia in a patient with chronic middle back pain: a case report

Resolution of Trifascicular Heart Block with Effective Closure of Congenital Atrial Septal Defect Followed by Later Coronavirus Disease 2019–associated Cardiac Strain

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