Masquerading details behind a murmur and chest pain
Masquerading bundle branch block (MBBB) is a rare presentation of bifascicular blocks. It is the result of a right bundle branch block associated with an advanced left anterior fascicular block due to extensive damage to the conduction system. We present the case of a 75-year-old male with late onse...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-01-01
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| Series: | Turkish Journal of Emergency Medicine |
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| Online Access: | https://journals.lww.com/10.4103/tjem.tjem_64_24 |
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| author | Alejandro Narvaez Orozco Alberto Navarro Navajas Alejandra Ramirez Roldan Camilo Lopez Ocampo Juan Manuel Senior Sanchez |
| author_facet | Alejandro Narvaez Orozco Alberto Navarro Navajas Alejandra Ramirez Roldan Camilo Lopez Ocampo Juan Manuel Senior Sanchez |
| author_sort | Alejandro Narvaez Orozco |
| collection | DOAJ |
| description | Masquerading bundle branch block (MBBB) is a rare presentation of bifascicular blocks. It is the result of a right bundle branch block associated with an advanced left anterior fascicular block due to extensive damage to the conduction system. We present the case of a 75-year-old male with late onset presentation anterior wall myocardial infarction (MI) with ongoing ischemia (which evolved into a ventricular septal defect [VSD]). Electrocardiographically, the MBBB is characterized by a prominent R in V1, left axis deviation and absence of small S waves in I and aVL. Its presence confers a poor prognosis and high risk of progressing to advanced atrioventricular block (AAVB). A mortality rate between 18% and 38.9% has been found and 41.4%–59% of the patients develop AAVB requiring pacemaker implantation. To our knowledge, this is the first reported MBBB case in the setting of an MI complicated with VSD, demonstrating its association with the presence of critical anteroseptal ischemia. The patient rejected any kind of intervention, palliative care was offered, and he died 2 months later. |
| format | Article |
| id | doaj-art-5d3ef2c8161143ac9a1b934dc241b2d4 |
| institution | DOAJ |
| issn | 2452-2473 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Turkish Journal of Emergency Medicine |
| spelling | doaj-art-5d3ef2c8161143ac9a1b934dc241b2d42025-08-20T03:15:31ZengWolters Kluwer Medknow PublicationsTurkish Journal of Emergency Medicine2452-24732025-01-01251596210.4103/tjem.tjem_64_24Masquerading details behind a murmur and chest painAlejandro Narvaez OrozcoAlberto Navarro NavajasAlejandra Ramirez RoldanCamilo Lopez OcampoJuan Manuel Senior SanchezMasquerading bundle branch block (MBBB) is a rare presentation of bifascicular blocks. It is the result of a right bundle branch block associated with an advanced left anterior fascicular block due to extensive damage to the conduction system. We present the case of a 75-year-old male with late onset presentation anterior wall myocardial infarction (MI) with ongoing ischemia (which evolved into a ventricular septal defect [VSD]). Electrocardiographically, the MBBB is characterized by a prominent R in V1, left axis deviation and absence of small S waves in I and aVL. Its presence confers a poor prognosis and high risk of progressing to advanced atrioventricular block (AAVB). A mortality rate between 18% and 38.9% has been found and 41.4%–59% of the patients develop AAVB requiring pacemaker implantation. To our knowledge, this is the first reported MBBB case in the setting of an MI complicated with VSD, demonstrating its association with the presence of critical anteroseptal ischemia. The patient rejected any kind of intervention, palliative care was offered, and he died 2 months later.https://journals.lww.com/10.4103/tjem.tjem_64_24bundle-branch blockchest painheart murmursmasquerading blockmyocardial infarction |
| spellingShingle | Alejandro Narvaez Orozco Alberto Navarro Navajas Alejandra Ramirez Roldan Camilo Lopez Ocampo Juan Manuel Senior Sanchez Masquerading details behind a murmur and chest pain Turkish Journal of Emergency Medicine bundle-branch block chest pain heart murmurs masquerading block myocardial infarction |
| title | Masquerading details behind a murmur and chest pain |
| title_full | Masquerading details behind a murmur and chest pain |
| title_fullStr | Masquerading details behind a murmur and chest pain |
| title_full_unstemmed | Masquerading details behind a murmur and chest pain |
| title_short | Masquerading details behind a murmur and chest pain |
| title_sort | masquerading details behind a murmur and chest pain |
| topic | bundle-branch block chest pain heart murmurs masquerading block myocardial infarction |
| url | https://journals.lww.com/10.4103/tjem.tjem_64_24 |
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