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Cardiology

Question
57 out of 57
 

Sudden LBBB is seen A/E (AIIMS May 2013)



A Hyperkalemia
B Acute MI

C Ashman’s phenomenon
D Hypokalemia

Ans. C

Ashman’s phenomenon

Disorders of ventricular conduction

Bundle branch block Delayed conduction is evidenced by prolongation of QRS >0.11s.

1. In RBBB, the following pattern is seen: QRS >0.11s, 'RSR' pattern in V1 dominant R in

2. V1, inverted T waves in V1-V4, deep wide S wave in V6.

3. Causes: normal variant Q (isolated RBBB), pulmonary embolism, cor pulmonale, MI, ASD, Ashman syndrome (AIIMS May 2013)

4. In LBBB, the following pattern is seen: QRS >0.11s, W pattern in V1, 'M' pattern in V5 – V6, no septal Q waves, inverted T waves in I, aVL, V5-V6.

Causes: IHD, hypertension, cardiomyopathy, idiopathic fibrosis.

Bifascicular block is the combination of RBBB and left bundle hemiblockQ Either left anterior fascicular block or left posterior fascicular block

Trifascicular block include:

a. Prolongation of the PR interval (first degree AV block)

b. Right Bundle Branch Block

c. Either left anterior fascicular block or left posterior fascicular block

Extra Edge:Trifascicular block also is said to occur in cases of alternating RBBB with LBBB (Ref. Hari-18th ed., Pg-1835)

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