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Are Incomplete RBBB And LAFB In The Heart A Cause For Concern?
Question: I am a 43 year old male with no chronic health concerns other than borderline hypertension (140/85). I recently changed PCP.s, and my new doc thought it wise to order labs and bloodwork to look for any indication that blood pressure was causing heart or kidney problems. All lab tests came back normal, but ECG showed incomplete RBBB and LAFB. I have no symptoms that would suggest an underlying heart condition. I am very worried and concerned about this---- should I be?
Brief Answer:
You shouldn't worry too much about!
Detailed Answer:
Hello,
Welcome on HCM!
Regarding your concern, I would like to explain that incomplete RBBB and LAFB are not rarely found in young normal healthy individuals.
So relax!
As long as you have not any obvious cardiovascular disorder, and no evidence of coronary risk factors (I suppose your blood lipid profile, glucose metabolism have resulted OK, and also you are not a smoker), besides a borderline high normal blood pressure (140/85 mmHg could not classify as hypertension and doesn’t deserve medical treatment), then your ECG findings would not be considered problematic.
In such case, it is not considered a marker of any underlying myocardial ischemia.
You shouldn’t worry too much about!
But, if from your ordered echocardiogram results some degree of left ventricular hypertrophy, then your average blood pressure values must have been much higher previously than the actual measured blood pressure.
Coming to this point hypertension would be considered a confirmed coronary risk factor and you need to follow further screening tests.
In that case a cardiac stress test is recommended for investigating a hidden coronary disorder.
I would like to directly review your cardiac ultrasound (ECHO) report when it becomes available.
Please could you upload your blood lipid profile report and any other medical test?
Also a prescription about any other present coronary risk factor (smoking? Glucose metabolism disorder? Obesity? Heredity for premature coronary artery disease? etc.)
Hope to have been helpful to you!
Feel free to ask me again, in case of any further uncertainties.
Kind regards,
Dr. Iliri
You shouldn't worry too much about!
Detailed Answer:
Hello,
Welcome on HCM!
Regarding your concern, I would like to explain that incomplete RBBB and LAFB are not rarely found in young normal healthy individuals.
So relax!
As long as you have not any obvious cardiovascular disorder, and no evidence of coronary risk factors (I suppose your blood lipid profile, glucose metabolism have resulted OK, and also you are not a smoker), besides a borderline high normal blood pressure (140/85 mmHg could not classify as hypertension and doesn’t deserve medical treatment), then your ECG findings would not be considered problematic.
In such case, it is not considered a marker of any underlying myocardial ischemia.
You shouldn’t worry too much about!
But, if from your ordered echocardiogram results some degree of left ventricular hypertrophy, then your average blood pressure values must have been much higher previously than the actual measured blood pressure.
Coming to this point hypertension would be considered a confirmed coronary risk factor and you need to follow further screening tests.
In that case a cardiac stress test is recommended for investigating a hidden coronary disorder.
I would like to directly review your cardiac ultrasound (ECHO) report when it becomes available.
Please could you upload your blood lipid profile report and any other medical test?
Also a prescription about any other present coronary risk factor (smoking? Glucose metabolism disorder? Obesity? Heredity for premature coronary artery disease? etc.)
Hope to have been helpful to you!
Feel free to ask me again, in case of any further uncertainties.
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr Iliri
Thank you for your assessment. I check my blood pressure pretty regularly (~5x per year) and I have a pretty long history of readings. It has never been higher than what I indicated to you.
I have never smoked, and my latest blood glucose is 88. I am not diabetic. I had a complete metabolic panel two days ago and everything was in normal ranges. I have NO family history of heart disease on either maternal or paternal side of the family. I am moderately overweight (5' 9", 195 lbs) but certainly not morbidly obese.
My latest blood lipid tests are:
Low-density lipoprotein: 101
Very Low-density lipoprotein: 22
Cholestrol: 168
Triglyceride: 108
High density lipoprotein: 45
These have been typical values for me over the last 10 years. I am scheduled to have the echo on Monday 2/8, so I will share the results when I have them.
Is there any chance that this finding could be an artifact of ECG lead placement or due to structural variations in heart placement or chest wall?
Thank you for your assessment. I check my blood pressure pretty regularly (~5x per year) and I have a pretty long history of readings. It has never been higher than what I indicated to you.
I have never smoked, and my latest blood glucose is 88. I am not diabetic. I had a complete metabolic panel two days ago and everything was in normal ranges. I have NO family history of heart disease on either maternal or paternal side of the family. I am moderately overweight (5' 9", 195 lbs) but certainly not morbidly obese.
My latest blood lipid tests are:
Low-density lipoprotein: 101
Very Low-density lipoprotein: 22
Cholestrol: 168
Triglyceride: 108
High density lipoprotein: 45
These have been typical values for me over the last 10 years. I am scheduled to have the echo on Monday 2/8, so I will share the results when I have them.
Is there any chance that this finding could be an artifact of ECG lead placement or due to structural variations in heart placement or chest wall?
Brief Answer:
Everything seems to be OK.
Detailed Answer:
Hello again,
It seems that you have not obvious coronary risk factors (your blood lipid profile, glucose level are OK, no history of diabetes or heredity for CAD).
At this point you should be relieved, as no any further test is warranted.
Cardiac ultrasound will confirm the fact of the absence of high blood pressure values, that is a structurally normal myocardium without evidence of left ventricular hypertrophy.
Regarding your ECG findings, I would prefer to directly review your ECG record.
It is quite possible that chest wall constitution influence the ECG findings.
Could you upload it here, please?
Regards,
Dr. Iliri
Everything seems to be OK.
Detailed Answer:
Hello again,
It seems that you have not obvious coronary risk factors (your blood lipid profile, glucose level are OK, no history of diabetes or heredity for CAD).
At this point you should be relieved, as no any further test is warranted.
Cardiac ultrasound will confirm the fact of the absence of high blood pressure values, that is a structurally normal myocardium without evidence of left ventricular hypertrophy.
Regarding your ECG findings, I would prefer to directly review your ECG record.
It is quite possible that chest wall constitution influence the ECG findings.
Could you upload it here, please?
Regards,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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