Is incidental Left Bundle Branch Block Benign?

Subscribe to Resus

Get the latest updates on our Conferences PLUS our Webcasts and Education Newsletters. And it's FREE!

  • We respect your privacy
  • This field is for validation purposes and should be left unchanged.

Register Now:

Sorry, we couldn't find any posts. Please try a different search.

Here’s the case. You see a 24 year old male who presents with a history of 2 minutes of pinpoint left chest pain 12 hours earlier. He has not had any pain since. At that time there was no shortness of Breath or radiation of the pain. The patient has no past medical history, is on no medications and has a normal clinical examination. The nurse performs an ECG and shows it to you. It is a Left Bundle Branch Block(LBBB). You actually feel a bit nervous about it and perform a troponin, which is normal. What do you do now?

In a 2005 study (Mayo Clin Proc) Miller et al., performed a retrospective study of 723 patients. Almost half of the patients had left bundle branch block(LBBB), the other half had right bundle branch block. Those patients with any form of bundle branch block and no complicating factors such as diabetes, hypertension or hypercholesterolaemia, had increased long term mortality compared to controls. Those with LBBB showed an increased risk of cardiac related morbidity. This has been found in many other epidemiological studies.

Littman (J Electrocardiol, 2000) looked at the effects of LBBB and found that it can cause asynchronous myocardial activation which may trigger ventricular remodelling. It is also associated with impaired systolic and diastolic function.

So what to do?

In this patient, who is well, with atypical and short-lived chest pain and a normal troponin, it is important to have follow up. This should take the form of an outpatient echocardiogram looking for valvular abnormalities or cardiomyopathy. If this is normal, then there is not much else to do, except to follow up over periods of time.

If there was any issue of coronary artery disease then the patient should also have a stress/thallium study.

Dr Peter Kas

Emergency Physician, Educator. Key Interests: Resuscitation, Airway, Emergency Cardiology, Clinical Examination. Creator


  1. Freda on 18/09/2021 at 10:53 am

    Your style is so unique compared to other folks I have
    read stuff from. Thanks for posting when you’ve
    got the opportunity, Guess I will just book mark this blog.

  2. TestoXmen on 18/09/2021 at 10:56 am

    Wow! This can be one particular of the most useful blogs We have ever arrive across on this subject.
    Basically Excellent. I am also a specialist in this topic therefore I
    can understand your effort.

    Look at my site TestoXmen

  3. on 18/09/2021 at 10:57 am

    Thanks a bunch for sharing this with all people you really recognise what you are speaking approximately!
    Bookmarked. Please additionally talk over with my site =).
    We could have a link exchange contract among us

    my webpage … Pure CBD Softgels Reviews (

  4. on 18/09/2021 at 11:03 am

    Appreciate the recommendation. Let me try it out.

    Feel free to visit my website – Ultra Quick Keto Burn Reviews (

  5. on 18/09/2021 at 11:08 am

    I really enjoy looking at on this internet site, it has fantastic content.

    Also visit my site: Bioneo Farms Pure CBD;,

  6. on 18/09/2021 at 11:20 am

    It’s a shame you don’t have a donate button! I’d certainly
    donate to this brilliant blog! I suppose for now i’ll settle for book-marking and adding your RSS feed to my Google
    account. I look forward to fresh updates and
    will share this site with my Facebook group. Chat soon!

  7. Ultra Quick Keto Cleanse on 18/09/2021 at 11:24 am

    Good blog! I really love how it is simple on my eyes and the data are
    well written. I am wondering how I might be notified whenever
    a new post has been made. I have subscribed to your feed which must do the trick!
    Have a great day!

    Feel free to visit my site – Ultra Quick Keto Cleanse

  8. on 18/09/2021 at 11:35 am

    Thank you a lot for providing individuals
    with remarkably superb opportunity to check tips from this site.
    It really is very enjoyable and as well , full of fun for
    me personally and my office acquaintances to visit your blog at least thrice in a
    week to see the newest things you have got. Of
    course, I am just always impressed concerning the awesome
    tips served by you. Certain 2 points on this page are clearly the most beneficial we have had.

    Also visit my homepage – Renew Brite Advanced Teeth Whitening (

  9. on 18/09/2021 at 11:40 am

    Hello, I want to subscribe for this webpage
    to obtain newest updates, so where can i do it please help out.

  10. cmd368 on 18/09/2021 at 11:43 am

    With havin so much content and articles dо you ever run into any issues
    of plagorism or copyright infringement? My blog hаs a llot oof unique
    contеnt I’ve either authored myself or outsourced but it seems a lot of it is poppіng itt ᥙup all over the web without
    mʏ agreement. Do you know any techniques to help
    protect against content from being stolen? I’d enuinely
    aрpreciate it.

  11. GrownMD CBD on 18/09/2021 at 11:45 am

    Thanks in support of sharing such a good thought, article
    is nice, thats why i have read it completely

    Have a look at my web site … GrownMD CBD

  12. on 18/09/2021 at 11:45 am

    Hello, after reading this amazing article i am too
    cheerful to share my familiarity here with friends.

  13. Tundra Breeze Portable Air Conditioner on 18/09/2021 at 11:56 am

    Thank you so much for providing individuals with
    a very spectacular possiblity to read from this site.

    It’s always so pleasurable plus jam-packed with amusement for me personally and my office colleagues
    to search your blog the equivalent of three times a week to read the
    new issues you will have. And definitely, I’m also usually impressed with all the awesome ideas you give.
    Selected two facts in this post are basically the simplest
    we’ve ever had.

    Also visit my web blog … Tundra Breeze Portable Air Conditioner

  14. on 18/09/2021 at 11:59 am

    Simply want to say your article is as surprising. The clarity in your publish is simply excellent and that i can think
    you’re a professional in this subject. Well together with your permission allow me to take hold of your feed to stay
    up to date with impending post. Thanks a million and please carry on the enjoyable work.

  15. on 18/09/2021 at 12:03 pm

    I blog often and I seriously thank you for your information. The article has truly
    peaked my interest. I am going to book mark your website
    and keep checking for new details about once a week.
    I subscribed to your RSS feed as well.

  16. Erectesto XL Male Enhancement on 18/09/2021 at 12:05 pm

    Keep up the fantastic work, I read few articles on this internet site and I believe that your
    blog is really interesting and contains bands
    of good information.

    My blog; Erectesto XL Male Enhancement

  17. Max Melt Keto on 18/09/2021 at 12:33 pm

    Good website! I really love how it is easy on my eyes and
    the data are well written. I am wondering how I could be notified when a new post has been made.
    I have subscribed to your RSS which must do the trick! Have
    a great day!

    my website – Max Melt Keto

  18. Mega Male Enhancement Review on 18/09/2021 at 12:40 pm

    I consider something really interesting about your
    web blog so I saved to fav.

    Feel free to visit my web-site :: Mega Male Enhancement Review

  19. Erectesto XL Ingredients on 18/09/2021 at 12:53 pm

    I enjoy, lead to I found just what I was having a look for.
    You’ve ended my 4 day lengthy hunt! God Bless you man. Have a great day.


    Feel free to visit my homepage … Erectesto XL Ingredients

  20. Max Melt Keto on 18/09/2021 at 1:01 pm

    Wow, amazing blog layout! How long have you been blogging for?
    you make blogging look easy. The overall look of your site is great, as well as the content!

    Feel free to visit my blog post: Max Melt Keto

  21. UltraXTend Review on 18/09/2021 at 1:04 pm

    Thank you a lot for providing individuals with an exceptionally special chance to read articles
    and blog posts from here. It’s always very fantastic
    and also jam-packed with a good time for me personally and my office
    peers to visit your website the equivalent of three times in one week to see the latest issues you have.

    And indeed, I am usually impressed with your dazzling tips you serve.

    Some 1 points in this post are basically the most impressive we have all ever had.

    my web blog; UltraXTend Review

  22. Pure CBD Softgels Cost on 18/09/2021 at 1:10 pm

    My brother recommended I might like this web site.
    He was totally right. This post actually made my day.
    You cann’t believe simply how a lot time I had spent for this information! Thanks!

    my page :: Pure CBD Softgels Cost

  23. on 18/09/2021 at 1:38 pm

    Hi, this weekend is nice for me, since this occasion i am reading this fantastic educational piece of writing here at my house.

    Look into my site Keto X3 (

  24. GrownMD CBD Review on 18/09/2021 at 1:40 pm

    I was curious if you ever thought of changing the page layout of your site?
    Its very well written; I love what youve got to say. But maybe
    you could a little more in the way of content so
    people could connect with it better. Youve got an awful lot of text for only having one or two
    images. Maybe you could space it out better?

    Stop by my blog post GrownMD CBD Review

  25. Alfonzo on 18/09/2021 at 1:48 pm

    Hello There. I found your blog using msn. This is a very well written article.

    I will make sure to bookmark it and come back to read
    more of your useful info. Thanks for the post. I will definitely return.

  26. on 18/09/2021 at 2:28 pm

    Hi there, this weekend is pleasant for me, because this occasion i am reading
    this impressive educational paragraph here at my residence.

  27. Mega Male Enhancement Pills on 18/09/2021 at 3:05 pm

    Hurrah, that’s what I was exploring for, what a data!
    present here at this webpage, thanks admin of this web

    Review my homepage Mega Male Enhancement Pills

  28. Quick Keto Trim Ingredients on 18/09/2021 at 3:32 pm

    I’m gone to inform my little brother, that he should also go to see this website on regular basis to get updated from
    hottest gossip.

    Take a look at my web site: Quick Keto Trim Ingredients

  29. Extreme Keto EFX Pills on 18/09/2021 at 4:52 pm

    I have been browsing online more than 4 hours today, yet I never found any interesting
    article like yours. It’s pretty worth enough for me.
    In my opinion, if all site owners and bloggers made good content as you did,
    the web will be a lot more useful than ever before.

    My website – Extreme Keto EFX Pills

  30. Nannie on 18/09/2021 at 5:52 pm

    When I originally commented I clicked the “Notify me when new comments are added” checkbox and now each time a comment is added I
    get several emails with the same comment. Is there any way you
    can remove people from that service? Appreciate it!

  31. Karolin on 18/09/2021 at 7:12 pm

    Great blog here! Also your website loads up fast!
    What host are you using? Can I get your affiliate link to your host?
    I wish my website loaded up as fast as yours lol

  32. Bioneo Farms CBD Review on 18/09/2021 at 9:58 pm

    Can you tell us more about this? I’d want to find out some additional information.

    Feel free to visit my web blog – Bioneo Farms CBD Review

  33. Phillip on 19/09/2021 at 8:37 pm

    Great post. I was checking continuously this blog and I am inspired!
    Very helpful info specifically the final phase 🙂 I maintain such info a lot.
    I used to be seeking this certain info for a long time. Thank you and good luck.

  34. Hollie on 20/09/2021 at 5:42 am

    I savour, lead to I discovered just what I was looking for.
    You’ve ended my four day long hunt! God Bless you man. Have a
    great day. Bye

  35. Wilburn on 20/09/2021 at 7:36 am

    My spouse and I absolutely love your blog and find almost all of your post’s to be precisely what I’m looking for.
    can you offer guest writers to write content for yourself?
    I wouldn’t mind producing a post or elaborating on a few
    of the subjects you write about here. Again, awesome website!

  36. Liam on 20/09/2021 at 8:40 am

    Good info. Lucky me I came across your site by chance (stumbleupon).
    I have bookmarked it for later!

  37. Sharron on 20/09/2021 at 8:57 am

    Unquestionably believe that which you said. Your favorite justification seemed to be on the net the easiest
    thing to consider of. I say to you, I definitely
    get annoyed while folks think about worries that they just do not realize
    about. You controlled to hit the nail upon the highest as neatly as outlined out
    the whole thing with no need side effect ,
    folks can take a signal. Will likely be back to get more.

  38. Danelle on 20/09/2021 at 10:43 am

    I really like what you guys tend to be up too. This kind of clever work and
    exposure! Keep up the fantastic works guys I’ve added you guys to my own blogroll.

  39. Kathrin on 20/09/2021 at 11:03 am

    Hey very nice blog!

  40. Alejandro on 20/09/2021 at 11:39 am

    Hi! I could have sworn I’ve been to this blog before but after reading
    through some of the post I realized it’s new to
    me. Nonetheless, I’m definitely glad I found it and I’ll be book-marking and checking back often!

  41. Chris on 20/09/2021 at 12:12 pm

    This paragraph is truly a good one it assists new web visitors, who are
    wishing for blogging.

  42. Google on 13/10/2021 at 5:55 am


    One of our visitors not long ago suggested the following website.

  43. taurus 454 raging bull on 13/10/2021 at 7:18 pm

    taurus 454 raging bull

    […]Here are some of the web sites we advise for our visitors[…]

  44. springfield saint edge for sale on 14/10/2021 at 3:35 am

    springfield saint edge for sale

    […]below you’ll come across the link to some websites that we believe you need to visit[…]

  45. sig p938 for sale on 14/10/2021 at 11:35 am

    sig p938 for sale

    […]Here is a good Blog You may Come across Exciting that we Encourage You[…]

  46. taurus 92fs stainless on 14/10/2021 at 4:29 pm

    taurus 92fs stainless

    […]here are some links to web-sites that we link to due to the fact we believe they may be really worth visiting[…]

  47. deckmate shuffler on 14/10/2021 at 5:51 pm

    deckmate shuffler

    […]Sites of interest we’ve a link to[…]

  48. mossberg 500a for sale on 14/10/2021 at 9:55 pm

    mossberg 500a for sale

    […]very handful of web-sites that transpire to become in depth beneath, from our point of view are undoubtedly well really worth checking out[…]

  49. sig sauer guns for sale UK on 21/12/2021 at 10:35 am

    sig sauer guns for sale UK

    […]Wonderful story, reckoned we could combine a number of unrelated data, nonetheless actually really worth taking a look, whoa did one understand about Mid East has got additional problerms as well […]

  50. sub2k for sale on 22/12/2021 at 6:25 pm

    sub2k for sale

    […]here are some hyperlinks to web-sites that we link to simply because we feel they may be really worth visiting[…]

  51. walther mp5 for sale on 22/12/2021 at 6:51 pm

    walther mp5 for sale

    […]here are some links to web-sites that we link to for the reason that we feel they’re worth visiting[…]

  52. on 24/12/2021 at 12:19 pm

    […]always a large fan of linking to bloggers that I really like but do not get a great deal of link appreciate from[…]

  53. buy psychedelics online on 27/12/2021 at 12:06 pm

    buy psychedelics online

    […]we like to honor many other web internet sites around the internet, even if they aren’t linked to us, by linking to them. Beneath are some webpages really worth checking out[…]

  54. Opana for sale online on 28/12/2021 at 11:34 pm

    Opana for sale online

    […]please visit the internet sites we adhere to, which includes this 1, as it represents our picks from the web[…]

  55. order Oxycodone online on 29/12/2021 at 7:44 am

    order Oxycodone online

    […]the time to read or stop by the content or sites we’ve linked to below the[…]

  56. Google on 01/01/2022 at 12:19 pm


    Always a big fan of linking to bloggers that I adore but don’t get a whole lot of link like from.

Leave a Comment