Incomplete blockade of the right and left bundle branch block

Conducting system of the heart, one component of which is a branch of the his bundle, ensure the normal rhythmic activity of the heart. If you have difficulty or cessation of the pulse legs disturbed heart rhythm, which could threaten a full shutdown and the death of the patient. Therefore, the conduction disturbances and blockades of the pulse should be treated responsibly and in time to begin treatment.

What is a blockade?

Bundles bundle branch block is changed the elements of the heart tissue included in the cardiac conduction system. For him are the excitatory impulses from the sinoatrial node to the heart muscle. Normal main generator of nerve impulses in the heart – the sinus node, which is the trunk of the atrioventricular node and is divided into right and left branches (legs), the so-called bundles bundle branch block.

Elements of the right bundle branch block, respectively go to the muscles of the right ventricle, and the left – to the muscles of the left. This provides simultaneous reduction of the right and left chambers of the heart. In case of incomplete blockade, the difficulty of the passage of nerve impulses, with full their complete cessation. This leads to disruption of the contractile function of the heart. Group causes of the blockade (the detailed reason will be discussed below):

  • Cardiac, that is, pathology of the heart.
  • Medical group of causes (or drugs) – as a result of the intake of certain medications.
  • The group, including changes in the electrolyte composition of the blood (potassium, sodium, magnesium, phosphorus).
  • A group of toxic factors, leading to poisoning of the body and causing blockade of conduction in the heart.
  • A group of autonomic disorders (autonomic nervous system), it is responsible for monitoring heart rhythm.
  • Hormonal causes (diseases of the endocrine organs).
  • Group causes oxygen starvation of the heart muscle.
  • Idiopathic causes that are not detected during examination of the patient.
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    Possible factors leading to incomplete blockade of the right bundle branch block

    This type of blockade is less common, but Teens and young adults is considered the norm. The reasons for the blockade can become enlarged (hypertrophied) right parts of the heart that interfere with the normal conduction of nerve impulses.

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      Неполная блокада правой и левой ножки пучка Гиса

    • Defect (hole) in the interatrial septum when it forms a window through which the blood from one half goes to another. Also damaged by the beam, which leads to the conduction disturbance.
    • Congenital or acquired heart defects, right when it departments are overloaded, which leads to their hypertrophy.
    • Pulmonary heart when the pressure in the pulmonary vessels increases, which leads to increased work of the right half of the heart and hypertrophy of his right.
    • Coronary artery disease and myocardial infarction often result in substitution of a portion of the heart muscle by connective tissue. These areas can no longer fully carry out nerve impulses, which leads to blockades.
    • Hypertension due to high vascular resistance leads to increased heart. Suffering as the right cardiac bags and left. Therefore, this pathology usually leads to the combined blockade of the right branch of the bundle branch block and left branches.
    • Chronic lung disease, occurring with obstruction (asthma, COPD).
    • Injuries to the thorax.
    • Metabolic disorders involving high levels of potassium in the blood (hyperkalemia).
    • Poisoning drugs quinidine, cardiac glycosides or beta-blockers.

    Reasons of incomplete blockade of the left branches

    • Atherosclerotic cardiosclerosis – substitution of part of the heart muscle by connective tissue.
    • Vices of the aortic valve. Such a defect leads to expansion and increase in the size of the left half of the heart that disrupts the conduction of nerve impulses in this part of the heart.
    • Cardiomyopathy, myocardiodystrophy, bacterial endocarditis – a disease characterized by damage to the myocardium (heart muscle) and with it Purkinje fibers (the smallest cell in the cardiac conducting system).
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    The types of incomplete blockade left side bundle branch block:

    • at the level of the left leg in the barrel of the beam;
    • blockade occurring in the left leg up until it is divided;
    • the shortness of the pulse in both branches after their separation;
    • option when to the previous view with the distribution of the lesions in half of the interventricular septum in the left part;
    • blockade at the level of extreme, the smallest of the branches of the branches of the left legs.

    Неполная блокада правой и левой ножки пучка Гиса

    Symptoms of incomplete closures

    Incomplete blockade of the right leg – one of the most benign forms of conduction disturbances in the heart. It is rarely manifested in any symptoms and are often detected incidentally during examination of the patient by the ECG. These patients will dominate the symptoms of the underlying disease that caused the blockade.

    Incomplete blockade of the left branches does not cause characteristic symptoms and is manifested by complaints on the part of the underlying disease. Sometimes the patient may be a violation of rhythmic contraction of the heart in the form of tachycardia (rapid contractions) or atrial fibrillation.

    The most difficult and dangerous option is trehochkovy the siege, when the nerve impulse is blocked and his right leg, and left branch bundle branch block. Manifested in the form of frequent dizziness, and sometimes loss of consciousness, problems in work of the heart. Life-threatening complication such blockade can be sudden cardiac arrest.

    Diagnostic signs of incomplete blockade feet beam Guisa

  • ECG. Diagnosis placed or confirmed after conducting the patient electrocardiogram. The electrical conductivity of the heart is reflected on the ECG, it is possible to determine the type of blockade and which legs are not enough conducts impulses. When right-wing blockades of the main changes will be visible in the right chest leads, with incomplete blockade of branches of the left legs, characteristic changes will occur in the left chest leads.
  • Transesophageal cardiogram is carried out in cases where standard x-ray not possible to lead.
  • Sometimes the patient requires daily monitoring of the heart activity (Holter study). In this case, the patient attached the device on the day, with him he keeps the rhythm of life, and the device records the heart rhythm and gives a cardiogram. The method is very convenient, as the blockade may not be constant and occur periodically.
  • Echocardiographic study of the heart conducted to determine the organic pathology of heart disease. It helps to find out the root cause of electrical blockade.
  • To determine organic pathology is CT or MRI. Methods of visualizing internal organs, help to identify any structural defects.