Bundle branch block: Difference between revisions
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*RBBB: [[atrial septal defect]], [[PE]], [[MI]] | *RBBB: [[atrial septal defect]], [[PE]], [[MI]] | ||
===ECG Changes=== | ===ECG Changes=== | ||
[[image:bbb.jpg|300px|thumb|right| | [[image:bbb.jpg|300px|thumb|right|Classicaly, the mnemonic is '''W'''i'''LL'''ia'''M''' and '''M'''a'''RR'''o'''W'''. However, '''V'''i'''LL'''hel'''M''' and '''M'''a'''RR'''oo'''N''' seems to be more accurate. Also, notice the '''wide QRS''' complexes. See the text if that doesn't make sense.]] | ||
If you're not sure about bundle branch block, | If you're not sure about bundle branch block, the classic mnemonic is '''W'''i'''LL'''ia'''M''' and '''M'''a'''RR'''o'''W'''. However, we think '''V'''i'''LL'''hel'''M''' and '''M'''a'''RR'''oo'''N''' gives a slightly more accurate picture. | ||
*'''L'''BBB: there is a ''' | *'''L'''BBB: there is a '''V''' shape in '''V1''' and an '''M''' shape in '''V6'''. The "V" wave is also called an rS wave because it has a very slight rise (r) and a big drop (S) in amplitude. The "M" wave, also called R, is just a large rise (R) with a tiny dip and tiny rise. | ||
*'''R'''BBB: there is an '''M''' shape in '''V1''' and | *'''R'''BBB: there is an '''M''' shape in '''V1''' and an '''N''' shape in '''V6''' (the '''N''' can also stand for "normal"). The "M" wave here has a small rise (r), a big drop (S) and an even bigger rise (R) giving an rSR wave. Finally, the N is your normal qRs complex but just wider. | ||
In both cases, there is a '''wide QRS''' complex. | In both cases, there is a '''wide QRS''' complex. | ||
===Management=== | ===Management=== | ||
[[ | Generally, you can just leave it but if the bundle branch block is severe, a [[pacemaker]] will need to be fitted. | ||
Latest revision as of 09:13, 6 April 2010
Definition
Cessation of appropriate electrical conduction down either the left of right bundle branch.
Pathophysiology
- LBBB: aortic stenosis, dilated cardiomyopathy, MI, CAD.
- RBBB: atrial septal defect, PE, MI
ECG Changes
If you're not sure about bundle branch block, the classic mnemonic is WiLLiaM and MaRRoW. However, we think ViLLhelM and MaRRooN gives a slightly more accurate picture.
- LBBB: there is a V shape in V1 and an M shape in V6. The "V" wave is also called an rS wave because it has a very slight rise (r) and a big drop (S) in amplitude. The "M" wave, also called R, is just a large rise (R) with a tiny dip and tiny rise.
- RBBB: there is an M shape in V1 and an N shape in V6 (the N can also stand for "normal"). The "M" wave here has a small rise (r), a big drop (S) and an even bigger rise (R) giving an rSR wave. Finally, the N is your normal qRs complex but just wider.
In both cases, there is a wide QRS complex.
Management
Generally, you can just leave it but if the bundle branch block is severe, a pacemaker will need to be fitted.