Left and right BBB

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define bundle branch block

a defect of the bundle branches/fascicles in the electrical conduction system

what happens in RBBB?

activation of the RV is delayed

what may you hear on auscultation of a patient with RBBB?

splitting of the 2nd heart sound

what shape is seen in the V1/V6 leads of someone with RBBB?

- 'M' in V1 - 'W' in V6 - opposite of LBBB

what shape is seen in the V1/V6 leads of someone with LBBB?

- 'W' in V1 - 'M' in V6

what causes RBBB?

- isolated congenital anomaly - or cardiac/pulmonary conditions

signs and symptoms of BBB?

- usually asymptomatic - may complain of syncope (due to intermittent complete heart block/ventricular tachyarrhythmia)

what happens in LBBB?

1. left bundle branches defect prevents/slows flow of conduction 2. activation of the LV is delayed 3. LV contracts later than the RV

what is seen on an ECG of someone with BBB?

= WIDENED QRS complex (>0.12s). different shape depending on L or R

what causes LBBB?

extensive left ventricular disease e.g. aortic stenosis, HTN

which BBB is always pathological?

left

what may you hear on auscultation of a patient with LBBB?

reverse splitting of the 2nd heart sound

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