Emergency care for an anginal attack. This is anginal pain. General characteristics of the phenomenon

If you believe literature and folk art, the heart is a very sensitive organ that can love, feel, think, and in addition, it is very fragile. From a medical point of view, only the last statement is true, despite the fact that it is the most strong muscle an organism that works without sleep or rest throughout its life. The main task of the heart is to ensure the movement of blood through the vessels, and it begins to perform this even in the process of intrauterine development. With pathologies of the cardiac system, the body is exposed to damage, since the importance of the proper functioning of this organ is very high, it is difficult to exaggerate. One of these pathologies is leg blockade.

With blockade (complete or incomplete), the normal passage of the sinus impulse through the cardiac system is disrupted, more precisely its path and travel time. This impulse, forming in the sinus node, should excite the atrium system. In case of violations, this does not happen or does not happen in the usual manner. Violations can be different: dangerous (complete blockades) and not so (incomplete). One of the serious dangers of blockade is the distortion of electrocardiogram results, which makes it difficult to diagnose many heart diseases, in particular myocardial infarction.

Left bundle branch block - what is the point?

Left bundle branch block (or LBBB) is a pathology that may be based on damage to the cardiac apparatus at various levels. For example, the left leg in the trunk of the His bundle may be affected. Or the main trunk of the left leg before branching. The anterior and posterior branches of the peduncle may be simultaneously affected after the point of their separation from the body of the main trunk. The left half of the septum between the ventricles is also damaged, and both branches of the pedicle are involved in the process. The reason may also lie in the peripheral branches of the posterior and anterior branches. With LBBB, the passage of excitation to the myocardium of the left ventricle along the left leg becomes difficult. It is carried out in an unusual way, as a result of which the QRS complex widens and the direction of repolarization in the left ventricle changes. We will not consider this in detail; this is a task for cardiac specialists. Let's look at some of the features of this disease. Damage to the leg may be the result of fibrotic processes that are associated with coronary sclerosis and, less commonly, with limited myocarditis (syphilitic, rheumatic, diphtheria, infectious). It is very rare, but it happens that blockade occurs in a completely healthy heart. Sometimes full and incomplete blockade left bundle branch. If we are talking about complete excitation, the excitation first covers only the septum between the ventricles, and not the entire ventricle. Incomplete blockade develops due to disturbances in electrolyte metabolism, or drug overdose, or various types of intoxication. Because of this, the typical conductivity of the cardiac system is disrupted, and full excitation of the left section does not occur. This disorder can be diagnosed using a regular electrocardiogram; changes will be visible when deciphered.

Is it dangerous?

If the blockade has spread to only one leg, then no, it is not life-threatening, although there is certainly nothing good about it. Many modern cardiologists believe that this deviation has ceased to be a deviation in cases where it is not a consequence of other heart diseases. Complete blockage of both legs is dangerous; in such cases, a pacemaker must be implanted.

Left bundle branch block: treatment and prevention

The main therapeutic measure that is relevant for incomplete blockade is identifying the disease that caused the blockade and its treatment. This disorder does not have a specific therapeutic complex. In cases where the patient suffers from hypertension, dangerous heart failure or angina pectoris, special therapy related to the support of the cardiac apparatus is required. It is carried out on the basis of drugs containing antihypertensive and antiarrhythmic drugs. In case of congenital defect, only surgical intervention is required. It happens that for young people such a blockade is the norm; this can only be determined by a specialist after a series of studies. Remember that self-medication can be dangerous to your health, especially when the issue concerns the heart. Be healthy!

For example, blockade of the bundle branches is associated with a pathology of the conduction of electrical signals through the myocardium of the heart, or more precisely, through the part of the conduction system responsible for contraction of the ventricles. The result of the development of pathology is a violation of the sequence, strength, speed of excitation, and contraction of the heart. In severe cases, there may be no contraction of any part of the myocardium at all, which can have unpleasant and even fatal consequences.

Features of the disease

The branch of His, or more precisely the branches of the bundle of His, is an element of the cardiac conduction system that is responsible for conducting excitation impulses in the region of the ventricles. There are three legs of the heart (bundle of His) - left, right anterior legs and one back. The last part of the bundle of His is thicker than the rest and is a continuation of the trunk of the bundle of His, and the left and right legs are its branches. There is a network of anastomoses between the branches of the bundle branches. The entire bundle of His consists of atypical muscle fibers. The end of the legs in the area of ​​the right and left ventricles breaks down into the smallest elements of the conduction system - Purkinje fibers.

The main function of the His bundle is to transmit impulses from the right atrium to the ventricles of the heart, which begin to contract in the rhythm of the atria. For any reason, children and adults may experience partial or complete disruption of impulse conduction at the level of one or two legs. In cardiology, such heart diseases are called bundle branch block (BBB). Pathologies often do not manifest themselves clinically, but are diagnosed in 6 people out of 1000 people. With age, the incidence of the disease increases, and after 55 years of age, blockades occur in 20 people out of 1000, more often in men.

The classification of the disease according to the degree of disruption of the conduction of excitation impulses into the ventricles is as follows:

1. Incomplete blockade of the His bundle (slowing of impulse transmission).
2. Complete blockade of the His bundle (complete cessation of impulse transmission).

In addition, the following types of blockades are distinguished:

1. Single-bundle - covers the right leg, or represents a blockade of the posterior or anterior branch of the left leg.
2. Double-bundle - affects both branches of the left leg or includes a blockade of the right leg coupled with damage to one branch of the left leg.
3. Three-bundle - the right and left legs are blocked.

According to the type of development of BBBB it can be:

• intermittent (appears and disappears during the recording of one ECG study);
• constant (always present on the ECG);
• transient (not recorded on all ECGs);
• alternating (can change location, that is, appear in the area of ​​different legs).

Causes of bundle branch block

Signs of pathology can appear in children from birth, and in this case they can be provoked by congenital diseases:

• defect of the interventricular and interatrial septum;
• underdevelopment of a segment of the right bundle branch;
• stenosis of the pulmonary artery;
• coarctation of the aorta;
• other heart defects that cause overload of the right ventricle.

IN childhood incomplete single-fascicle blockades can be considered a variant of the norm if they are not accompanied by organic heart damage. Thus, in many children, incomplete blockade of the right bundle branch is detected, combined with minor cardiac anomalies - additional chord, mitral valve prolapse, etc. Blockade of the left leg is more often provoked by acquired diseases and is often also considered a variant of the norm.

Among the cardiac causes that can cause RBBB, doctors name the following:

• acute and chronic heart failure;
• myocarditis of viral, bacterial origin;
• rheumatism of the heart;
• endocarditis;
• various cardiomyopathies;
• myocardial dystrophy of the heart;
• cardiosclerosis;
• heart tumors, metastatic heart lesions;
• chest injuries;
• surgical interventions on the heart, coronary vessels;
• autoimmune pathologies that affect the heart muscle;
• heavy arterial hypertension, or long-term hypertension;
• myocardial infarction.

There are other reasons that can lead to partial or complete blocks of the bundle branches, including transient ones:

• chronic diseases respiratory system accompanied by obstructive processes, for example, bronchial asthma, emphysema, cor pulmonale, Chronical bronchitis;
• pulmonary embolism;
• progressive muscular dystrophy;
• hyperkalemia, as well as other electrolyte disturbances - disruptions in the balance of magnesium and sodium;
• overdose of certain drugs - cardiac glycosides, diuretics, antiarrhythmics, etc.;
• long history of smoking;
• alcoholism;
• autonomic dysfunction nervous system;
• diseases of the adrenal glands, thyroid gland;
• diabetes;
• severe anemia.

In the absence of obvious causes, after the diagnosis, an idiopathic bundle branch block may be established.

Symptoms of manifestation

Many clinical cases of RBBB occur without any symptoms. Incomplete single-fascicle blocks almost never show symptoms, so they are detected only by ECG during a routine examination. But with complete blockade of the right leg, symptoms are usually observed in a person even in the absence organic lesions hearts. These include:

• various changes when listening to heart sounds;
• dizziness;
• presyncope and fainting;
• feeling of lack of air;
• dyspnea;
• decreased performance;
• poor exercise tolerance;
• fatigue and weakness;
• sometimes - pain in the heart area;
• feeling of interruptions in the work of the heart.

In addition, a clinical picture may appear that corresponds to the underlying disease - both cardiac and affecting other organs and systems. The most serious symptoms appear in acute cardiac pathologies - heart failure, myocardial infarction, which are most often accompanied by various heart blocks against the background of damage to the ventricular myocardium.

Danger and consequences

The prognosis for this disease is difficult to predict, since, in fact, it is a symptom of other pathologies. If the patient has an incomplete single-fascicle block without cardiac or pulmonary diseases, the prognosis is favorable. With regard to the presence of organic heart lesions, the prognosis depends entirely on the underlying pathology. As for the danger of BBBB, then unpleasant consequences, as a rule, occur with complete blockades. They lead to progressive hemodynamic disorders, which can cause the following complications:

• stroke - acute ischemia area of ​​the brain against the background of cessation of blood circulation in it;
• chronic heart failure - dysfunction of the heart, leading to disruptions in the functioning of the entire body;
• worsening of the underlying heart disease;
• the appearance of thrombosis and thromboembolism due to blood thickening.

Complete RBBB is dangerous - with age, if left untreated, it can lead to the development of severe types of arrhythmias - paroxysmal ventricular tachycardia, ventricular fibrillation, which ends in cardiac arrest (the likelihood of death is highest with a three-bundle block).

Pulmonary embolism and ischemic stroke can also lead to death. On average, mortality when blockade develops against the background of a heart attack is 50% in the first days of the pathology. Such consequences can only be prevented by an early start of examination and treatment, compliance with all doctor’s prescriptions, and getting rid of or correcting underlying diseases of the heart and blood vessels.

Diagnosis of pathology

Even a therapist, when listening to the heart, can note a change in rhythm, a disturbance in heart rate. This should be a reason to perform further, more detailed examination to find the cause and type of heart block. The main diagnostic method is an ECG, which can be used to draw a conclusion about the form of RBBB (the most common types of blockades are presented below):

1. Blockade of the anterior branch of the left LES. There is a high R wave, a deep S wave, and a deviation of the QRS vector up to the left.
2. Blockade of the posterior branch of the left LES. The QRS vector is directed upward, to the right and forward, there is a high R wave, a deep S wave. Both types of blockades can be accompanied by acute heart failure, myocardial infarction, which should not be forgotten when obtaining such examination results.
3. Blockade of the right LES. There is a tall, wide R wave, a widened S wave, and increased amplitude. The ventricular QRS complex takes the form qRS or rSR and widens to 0.12 seconds. and more. In addition to acquired causes (anterior myocardial infarction, ischemic heart disease), this variant of the development of the disease is typical for birth defects heart and other diseases.
4. Blockade of the left LES. The EOS deviates to the left or is located horizontally. The QRS is shaped like a widened R wave with a jagged or flattened apex. The width of the ventricular QRS complex is greater than 0.12 seconds or equal to this indicator. The condition is typical for arterial hypertension, acute myocardial infarction (less commonly), aortic defects hearts.
5. Double bundle block (blockade of the right leg and left anterior branch). The QRS complex is widened over 0.12 seconds, the T segment is negative, and the RS-T segment is shifted downward, the EOS is deviated to the left. This change is most typical for ischemic heart disease and other myocardial pathologies.

After identifying these abnormalities in the ECG, the patient is recommended to perform other examinations that will help to detail the information and establish the correct diagnosis:

1. Blood and urine tests to assess electrolyte balance, hormone levels, indicators of autoimmune processes, etc.
2. Daily ECG monitoring to identify unstable atrial conduction disturbances, type of arrhythmias, assess the severity of blockades, search for nocturnal or stress blockades.
3. Ultrasound of the heart to determine the cardiac causes of heart block, especially organic heart lesions.
4. EFI to clarify data about the disease when ECG or Holter monitoring does not allow making an unambiguous diagnosis.

Treatment options

For incomplete single-bundle blocks, as a rule, no treatment is required. If there are no cardiac causes for such disorders, then they are unlikely to progress or be aggravated by other pathologies. Such RBBB almost never develop into complete blockades and do not threaten life. Occasionally, especially against the background of hypertension, progression of right leg block and second or third degree AV block is possible. When such processes begin, the doctor always prescribes preventive drug therapy.

The same should be done for more serious types of blockades. A set of medications is selected from the medications and is carried out in courses. Treatment of the underlying disease is also mandatory. In general, drug treatment for blockades may include the following drugs:

1. Vitamins in injections - thiamine, riboflavin, nicotinic acid and others.
2. Sedatives - motherwort, valerian.
3. Antioxidants - Mexidol, Preductal, Carnitine.
4. High blood pressure medications from different groups(blockers calcium channels, ACE inhibitors, beta-blockers, etc.) - Betaloc, Valsartan, Verapamil, Amlodipine.
5. Drugs against cardiac ischemia, mainly nitrates - Nitroglycerin, Cardiket.
6. Medicines for high cholesterol- Rosuvastin, Simvastatin.
7. Cardiac glycosides and diuretics for heart failure - Digoxin, Lasix.
8. Antiplatelet agents against thrombosis - Cardiomagnyl, Aspirin-Cardio.
9. Medicines against chronic pulmonary obstruction - Pulmicort, Berodual, Beclazon.

Currently, several types of surgical interventions have been developed, which are most often recommended for patients with complete blockade of one branch, or with two- or three-bundle blockades. The most commonly used technique is implantation of an electrical pacemaker, including a temporary one (for a heart attack and other acute conditions). For some types of conduction disorders, the method of radiofrequency catheter ablation helps. Some patients should also have a cardioverter-defibrillator installed, for example, with a three-fascicular block combined with a complete ventricular-atrial block.

In general, a person with blockades without manifestations can lead a normal life, but should immediately give up excessive physical activity, get more rest, and avoid prolonged stress. Nutrition must be correct, without an abundance of salt and animal fats and sugar. You should give up bad habits, especially smoking. After having a pacemaker installed, a person should initially visit a cardiologist once every three months, and then once every six months and a year. Some people use folk remedies against heart block. By agreement with the doctor, the following prescriptions from the section of alternative medicine are allowed:

1. Combine equal amounts of valerian root, rose hips, dandelion roots, calamus roots, and grind everything in a coffee grinder. Take a teaspoon of reset, pour 300 ml of boiling water. Drink 100 ml three times a day for 1 month.
2. Combine pharmaceutical alcohol tinctures of hawthorn (50 ml), valerian (30 ml), motherwort (40 ml), calendula (20 ml), peony (80 ml), mint (20 ml). Take 10 drops three times a day after diluting in water for a course of 1 month. With a strong decrease in pressure, the dose is reduced to 5-7 drops.

Preventive measures

To prevent illness, the following measures are important:

• rest more, get enough sleep;
• eliminate stress and overwork;
• observe the work and rest schedule;
• there is only healthy food, consume more plant fiber;
• give up cigarettes and alcohol;
• take all medications only in recommended doses and under the supervision of a physician;
• treat all heart diseases early.

Are you one of the millions who have heart disease?

Have all your attempts to cure hypertension been unsuccessful?

And have you already thought about radical measures? It’s understandable, because strong heart is an indicator of health and a reason for pride. In addition, this is at least human longevity. And the fact that a person protected from cardiovascular diseases looks younger - an axiom that does not require proof.

The materials presented are general information and cannot replace medical advice.

Left heart block

In order to understand what blockade of the left ventricle of the heart is, you need to know how a healthy human heart, as well as how its conducting system is organized.

Our heart consists of ventricles and atria, which contract in turn to provide blood circulation to the entire body. The heart works under the influence of electrical impulses that are produced by its specific structures.

The sinus node is the dominant impulse-generating structure. After the impulse leaves this node, it is carried out to the atria, which contract because of this. Then it reaches the atrioventricular node. This node is located between the ventricles and atria and is a kind of gateway for the eclectic impulse between these two structures. The impulse is delayed for a fraction of a second in the atrioventricular node. This is necessary so that the blood has time to move from the atria to the ventricles. Then this impulse is carried out along the trunk of the His, reaching the ventricles, thereby forcing them to contract and pour blood into the general channel.

So, in simple terms, left ventricular His bundle block is a conduction disorder in which the electrical impulse stops or slows down.

Blockade of the left ventricle of the heart appears against the background of ischemic or hypertension or a number of other cardiovascular diseases.

Classification

Blockade of impulse conduction can occur anywhere in the leg, and it can be complete or incomplete. And since the left leg is divided into the back and front parts, various classification options arise:

Consequences of complete blockade of the left bundle branch

The heart is a unique organ that governs itself, i.e. has automaticity, but, of course, taking into account the needs of the body and not without interfering with the work of the nervous and endocrine systems. This organ is not just a muscle sac, which is a pump for pumping blood; the heart is much more complex than it might seem.

The structure of the heart and the resulting causes of blockades

In addition to the muscles, four cavities, valves, and its own coronary vessels, it has a conduction system and its two centers (pacemaker). From the main center (the pacemaker of the first order), electrical impulses enter the second, and then along the left and right branches of the His bundle they spread to the entire myocardium, which then contracts (and pushes blood out of the heart).

Naturally, if there is a blockade, in this case a complete blockade of the left bundle branch. therefore, the impulse cannot spread further, and this leads to disruption of the rhythm and, in general, the work of the entire heart. The reason for this may be myocardial infarction; it should be assumed first of all if the blockade occurred for the first time. Other causes: cardiosclerosis, cardiac dystrophy, hypertonic disease, cardiomyopathy, myocarditis, etc.

Consequences of the blockade

Complete blockade of the left bundle branch leads to disruption of the conduction of electrical impulses to the left ventricle. But even despite the complete blockade, the impulse still passes, but along bypass routes (anastomoses), and with a delay.

What is the danger of complete blockade of the left bundle branch?

Even a complete bundle branch block may be asymptomatic and may not initially pose a serious threat to life. However, over time, the condition worsens, ventricular arrhythmia develops, more often one of its types is ventricular paroxysmal tachycardia. It is this that ultimately leads to ventricular fibrillation: random contraction of myocardial muscle fibers, which is incompatible with life and inevitably leads to death.

Treatment

There is no specific treatment for blockade. With this pathology, treatment is aimed at eliminating the underlying disease, which caused the blockade. As a rule, cardiac glycosides, nitrates, and blood pressure-lowering drugs are prescribed. If the heart rhythm does not recover, then they resort to surgery: installing a pacemaker.

Rehabilitation for cardiac arrhythmia

Besides drug therapy of the underlying disease causing the blockade, treatment should include additional non-drug methods related more to rehabilitation measures. In general, this tactic is suitable for other causes of left ventricular block. For example, physical therapy. Physical exercise They tone not only the entire body, but have a particularly beneficial effect on the cardiovascular system, increasing the supply of oxygen and generally reducing the mechanical load on the heart. Simply put, by moving, we help the heart accelerate blood. Certainly strength exercises don't fit here. Choices: Walking or jogging. But in physical therapy It is very important, especially in case of heart disease, that the load is dosed and adequate to the capabilities of the heart. Otherwise, you may get a negative effect.

Left ventricular block

The heart muscle has special properties compared to other organs human body. One of these properties is the conductivity of impulses that arise in special structures of the cardiac tissue. Sometimes it happens that the impulse is not transmitted by the heart cells. Such conditions are called blockades.

Block of the left ventricle of the heart or, as it is called in medical practice, blockade of the left bundle branch in most cases is only a complication of the disease. Accordingly, if there is damage to the right bundle branch, blockade of the right ventricle of the heart occurs. Diseases that can lead to blockade occur both in young people (heart defects) and in old age (arterial hypertension, ischemic conditions hearts, etc.).

For reference

IN Lately Left ventricular block is used as a term that has a broader concept than “left bundle branch block.” This is due to the mechanism of impulse transmission. The fact is that the left bundle branch is divided into two legs: anterior and posterior. Sometimes the block occurs at the site of division into the anterior and posterior branches; in such cases, diagnosis by establishing the level of the lesion is difficult. As a result, they decided to introduce a more extensive concept.

Types of blockades

In addition, blockade of the left ventricle can be complete or incomplete. An incomplete blockade does not pose any danger to life. The symptoms that are observed with it are weakness, slow pulse (bradycardia). If an incomplete blockade is detected on the ECG, the signs of which will be a deviation electrical axis heart to the left and left ventricular hypertrophy, the main thing is to exclude myocardial infarction, which is very often “masked” in the lines of the cardiogram with incomplete blockade of the left ventricle.

Symptoms and ECG

The main tool in diagnosing “blockade...” is an electrocardiogram, which may look different in the same cases, although it was done on the same device.

Things are very serious with complete blockade of the left bundle branch (left ventricular block). First, I would like to tell you what happens normally: the left ventricle is “responsible” for releasing oxygenated blood into the aorta. If the left ventricle fails, the release of oxygenated blood is delayed or stopped, which leads to oxygen starvation of all organs and systems (primarily the brain). Clinically, this is manifested by breathing disorders (shortness of breath), dizziness, drowsiness, a decrease in heart rate to 25 beats/min and, in the end, acute heart failure, which can result in death if timely and correct medical care is not provided.

Diagnosing a complete blockade with an experienced doctor does not pose any particular difficulties. Everything will be visible on the ECG. Provided there is no other pathology.

Dangerous conditions

Complete blockade and myocardial infarction or complete blockade and unstable angina are very common. It is much more difficult to treat complete blockades. To date, there are no specific recommendations on this matter. The main thing is to stop acute condition, and then prevent recurrences, so to speak, carry out prevention. Also read about the consequences of a complete block of the left bundle branch.

This condition can be cured in different ways, including the use of an electric defibrillator. Then, when the condition has stabilized, drug therapy is carried out, drugs that improve the quality of life (beta blockers, etc.), and antiarrhythmic drugs are prescribed.

Prevention

It is advised to follow a diet (blockades often occur due to obesity). All this is for older people who have, so to speak, “acquired” diseases. For persons with the most defects in the best possible way The treatment is heart surgery to correct the defect. Another direction in treatment is the installation of a pacemaker. In modern conditions, the approach to all patients is individual.

My son has schizophrenia, I am his guardian. He takes haloperidol 3 times, cyclodol 2 times, aminazine 100 mg at night and phenazepam 2 mg at night. On ECG complete blockade of the left bundle branch and incomplete block of the right bundle branch, they write: possible overload of the right ventricle. I walk with him on the street, his weight is 84 kg, his height is 167 cm. His “heart” is not complaining. There are “voices” in your head. In September, after September 14, an MSE examination was scheduled for the purpose of rehabilitation for the underlying disease (paranoid schizophrenia, continuous progressive course).

The therapist prescribed asparkam. It's 08.10. Born 1973. Need a cardiologist?

Of course I need it. I have a complete blockade of my left leg. A pacemaker was installed. I'm 26 and have had a stimulant since I was 17 years old.

I have a complete blockade of the left bundle branch. IT IS POSSIBLE TO DO SURGERY FOR UTERUS PROPRESSION. AND I WANT TO KNOW THE RECTUM. AND HOW TO CONTINUE TO LIVE

Incomplete blockade of the left bundle branch: causes, symptoms and treatment

Absolutely each of us knows that thanks to the work of the heart, the entire body functions. And when it fails, irreversible health processes begin, especially with late diagnosis and improper treatment.

The danger of this disease lies in the absence of symptoms early stages, the edge of the main pathology and can be identified using an ECG. But if you notice one of the signs indicated in the article, do not put off visiting a cardiologist, because this can lead to more serious complications. What is an incomplete block of the left bundle branch, how does it manifest itself, diagnostic methods and treatment methods, we will consider below.

What is a blockade?

The bundles of His are modified elements of cardiac tissue that are part of the conduction system of the heart. Exciting impulses pass through them from sinus node to the heart muscle. Normally, the main generator of nerve impulses in the heart is the sinus node, from which the trunk goes to the atrioventricular node and is divided into the right and left branch(legs), the so-called bundles of His.

The elements of the right bundle of His, respectively, go to the muscles of the right ventricle, and the left ones - to the muscles of the left. This ensures synchronous contraction of the right and left parts of the heart. With an incomplete blockade, the passage of nerve impulses becomes difficult, with a complete blockade, their complete cessation occurs.

This leads to disruption of the contractile function of the heart. Groups of reasons causing blockades (detailed reasons will be discussed below):

1. Cardiac, that is, pathologies of the heart.
2. Medicinal group of causes (or medicinal) - as a result of taking certain medications.
3. A group that includes changes in the electrolyte composition of the blood (potassium, sodium, magnesium, phosphorus).
4. A group that combines toxic factors that lead to poisoning of the body and cause conduction blockades in the heart.
5. A group of autonomic disorders (autonomic nervous system), it is responsible for controlling the heart rhythm.
6. Hormonal causes (diseases of the endocrine organs).
7. A group of reasons that cause oxygen starvation of the heart muscle.
8. Idiopathic causes that are not determined during examination of the patient.

Types of blockades

If electrical discharges from the upper chambers are not transmitted as they should to the lower chambers, a bundle branch block occurs. This is reflected in the cardiogram.

As a rule, all blockades are divided into 3 main types:

• Single-bundle - it can affect the right leg, as well as one of the branches of the left process.
• Two-bud - this variety immediately affects both left-sided branches or the right and one of the branches of the left.
• Three-bundle is the most serious pathology in which 3 branches are affected at once.

In turn, LBBB can occur in several scenarios:

• the blockade occurs in a certain part of the trunk up to the branching boundary;
• The stem part is completely affected before it branches;
• the blockade affects the process on both sides after branching;
• both peripheral parts of the left process are blocked;
• scattered changes on average muscle layer hearts.

Incomplete blockade of the left bundle branch - characteristics

By incomplete blockade we mean a violation of the conductivity of the electrical signal along one of the branches of the left leg. To determine which part is suffering, the electrographic deviation of the total vector of the electrodynamic force of the heart is assessed at the position of the recording electrodes on the right upper and left lower extremities.

If there is a pronounced deviation of the total vector of the electrodynamic force of the heart to the left, then a blockade of the anterior branch is diagnosed, and if a pronounced right-branch is observed, then this indicates damage to the posterior branch.

As a rule, incomplete LBBB does not cause serious clinical abnormalities and no abnormalities are observed when listening to the patient. And if an incomplete blockade of the right leg is detected, then the condition can be regarded as corresponding to the physiological norm and further examination is not necessary in this case.

Left bundle branch block (or LBBB) is a pathology that may be based on damage to the cardiac apparatus on different levels. For example, the left leg in the trunk of the His bundle may be affected. Or the main trunk of the left leg before branching.

The anterior and posterior branches of the peduncle can be affected at the same time at the end of the place where they are separated from the body of the main trunk. The left half of the septum between the ventricles is also damaged, and both branches of the pedicle are involved in the process.

The circumstance may also lie in pronounced diffuse transformations of the myocardium in the peripheral branches of the posterior and anterior branches. With LBBB, the passage of excitation to the myocardium of the left ventricle along the left leg becomes difficult.

It is carried out using an unusual method, as a result of which the QRS complex widens and the direction of repolarization in the left ventricle changes. We won’t look at this in detail; this is a task for heart experts. Let's look at some of the features of this disease.

Damage to the leg may be the result of fibrotic processes, which are associated with coronary sclerosis and, less commonly, with limited myocarditis (syphilitic, rheumatic, diphtheria, infectious). It is very rare, but not uncommon, that a blockage appears in a completely healthy heart.

Complete and incomplete blockade of the left bundle branch is not uncommon. If we are talking about complete excitation, the excitation first covers only the partition between the ventricles, and not the entire ventricle. Incomplete blockade begins with disturbances in electrolyte metabolism, or drug overdose, or various types of intoxication.

As a result, the normal conductivity of the cardiac system is disrupted, and full excitation of the left section does not occur. It is possible to diagnose this disorder using a simple electrocardiogram; when deciphered, transformations will be visible.

If the blockade has spread to only one leg, then no, it is not life-threatening, despite the fact that there is certainly nothing good about it.

Many modern cardiologists are confident that this deviation has already ceased to be a deviation in those cases when it is not the result of other heart diseases. Complete blockage of both legs is scary; in such cases, a pacemaker must be implanted.

Causes

The causes of the pathology include:

• Atherosclerotic cardiosclerosis is the replacement of part of the heart muscle with connective tissue.
• Aortic valve defects. This defect leads to expansion and increase in the size of the left half of the heart, which disrupts the conduction of nerve impulses in this part of the heart.
• Cardiomyopathy, myocardial dystrophy, bacterial endocarditis are diseases characterized by damage to the myocardium (heart muscle) and with it Purkinje fibers (the smallest cells in the conduction system of the heart).

Types of incomplete blockade of the left side of the His bundle:

• at the level of the left leg in the very trunk of the bundle;
• blockade occurring in the left leg until it is divided;
• difficulty in conducting an impulse in both branches after their separation;
• an option when the previous type is joined by the spread of the lesion to half of the interventricular septum in its left part;
• blockade at the level of the extreme, smallest branches of the branches of the left leg.

Drug intoxication of the body plays an important role in the occurrence of this disorder. In this case, poisoning with diuretics, cardiac glycosides, and sympathomimetic drugs is observed.

Sometimes the blockade develops due to excessive consumption of alcoholic beverages, smoking, narcotic substances. Also appearance of this disease may be a consequence of deviations in electrolyte balance body.

The development of His bundle block is caused by magnesium deficiency, deficiency or excessive amount of potassium. Also, the reason for the development of blockade may be the appearance of thyrotoxicosis.

The causes of damage to the anterior and posterior branches of this part of the organ may differ significantly. Thus, the following factors most often lead to problems in the functioning of the anterior branch:

• anterior infarction;
• arterial hypertension;
• aortic valve defect;
• cardiosclerosis;
• mitral insufficiency.

Also, blockade of the anterior branch of the left leg may be the result of a violation of the integrity of the septum between the atria. It is often caused by cardiomyopathy and calcium salt deposits.

Often the reason for the deviation lies in inflammatory process, which affects the heart muscle. Violation of the posterior branch develops under the influence of such factors:

• atherosclerosis;
• heart attack, which is characterized by posterior localization;
• deposition of calcium salts;
• myocarditis.

In more rare cases, a two-fascicle blockade may be detected - in this case, both the anterior and posterior branches of the organ are affected.

Significant changes in hormonal levels caused by certain external influences are also additional causes of left bundle branch block.

The most common etiological factors that can largely influence the occurrence of the first signs of blockade include the following:

1. Poisoning of the patient’s body with a large amount of residues of drugs that were used in the treatment of concomitant heart diseases. These include different kinds diuretics, symptoms and cardiac glycosides;
2. Abuse of bad habits that negatively affect the entire human cardiac system. This could be alcoholism, drug use, smoking;
3. Thyrotoxicosis;
4. Insufficient amounts of certain substances in the body. These are potassium and magnesium, which are responsible for electrolytic balance in the body. A significant amount of them, as well as some of their deficiency, affect the balance in the functioning of the cardiac system.

As a result of the above situations, the anterosuperior bundle loses its rhythm of work; ventricular contractions occur regardless of the receipt and conduction of impulses through the tissues of the leg.

Anterior branch block

When blocking the anterior branch of the left bundle branch, uniform disturbances are determined regardless of the location of the lesion. This is explained by the fact that the reaction of the excitable structure does not reach upper sections anterior wall of the left lower chamber of the heart.

Therefore, using standard electrocardiography it is impossible to accurately determine the location affected by the block.

With LPVPL, excitation in the right lower cardiac chamber occurs in a standard manner. In the lower left chamber, the reaction of the excitable structure spreads in stages.

First it passes along the posterior branch of the left leg, and then spreads to the upper parts of the left-sided lower chamber.

This deviation can be detected against the background of a number of cardiac pathologies:

• chronic myocardial damage, which is based on pathological processes in the system coronary arteries and this especially applies to the front wall of the left-sided lower chamber;
• ischemic necrosis of the myocardium of the anterior wall of the left-sided lower chamber;
• inflammation of the heart muscle;
• significant thickening of the wall of the left ventricle;
• pathological enlargement of the left lower chamber of the heart caused by aortic valve insufficiency;
• primary isolated sclerosis and calcium deposition in the walls of the conduction system;
• congenital heart defects.

According to statistics, LBBB manifests itself over the age of 50 years in 1.25% of male patients. And in most cases, this indicator is the only sign of developing pathology in the muscular middle layer of the heart.

Posterior branch block

When the posterior branch of the left bundle branch is blocked, serious conduction disturbances occur in the posterior branch, which can occur with different indicators. The ECG shows identical abnormalities that are difficult to differentiate using standard electrocardiography.

This condition develops with pathologies similar to those with LPVPL:

• insufficiency of blood supply to the myocardium;
• atherosclerosis of the coronary arteries;
• necrosis of a portion of the myocardium affecting the left ventricle;
• inflammation and other changes in the heart muscle caused by a variety of reasons;
• calcium deposition and tissue degeneration into hard connective tissue.

If we talk about blockade of the anterior branch, then in electrocardiography this is a fairly well studied section. And defeat of the posterior branch does not give specific signs, and this section is still under development. It is impossible to diagnose damage to the posterior branch based solely on the results of a standard cardiogram.

As a rule, to clarify, you need to resort to additional methods diagnostics In any case, any of the above blockades is detected during a full examination and the specialist, if necessary, will prescribe additional research before making an accurate diagnosis.

Symptoms

Single-fascicular block is asymptomatic and is detected by ECG. Signs of the disorder such as constant fatigue, chest pain, shortness of breath, in this case are caused by the disease that caused the disorder electrical conductivity.

Signs of blockade of the left leg of the anterior or posterior branch are also not felt by the patient. Complete left block gives symptoms such as: dizziness, heart pain, palpitations. The symptoms are caused by severe changes in the left ventricular muscle (myocardial infarction).

Incomplete blockade of the left bundle branch of His, trifascicular, is characterized by the following symptoms:

• interruptions in heart function;
• persistent fainting caused by oxygen starvation brain;
• dizziness.

Three-bundle incomplete blockade leads to sudden death.

Diagnosis of electron conduction disorders of the His bundle

A problem with electrical conductivity is shown by a cardiogram. Right incomplete blockade, in the absence clinical symptoms And concomitant diseases is considered normal and no additional examinations are carried out.

ECG signs of double-fascicular blockade serve as a reason for hospitalization of the patient, as there is a risk of development severe conditions. A three-bundle His bundle block detected on an ECG also requires immediate hospitalization followed by surgery.

How to see a problem with the electrical conductivity of the His bundle on a cardiogram. Signs of right leg block:

• Rsr or rSR complexes in V 1, V2 (right leads).
• Wide S wave in V5, V6 (left leads).
• QRS complex is more than 0.11 s.

Signs of conduction disturbance of the left leg:

• left leads V5, V6, I do not have a Q wave;
• ventricular complexes are deformed;
• the apex of the R wave is split;
• right leads V1, V2, III are characterized by a deformed apex of the S wave, the width of the complex is more than 0.11 s.

Differences between three-bundle blockade:

• all signs of left and right;
• ECG picture shows atrioventricular block.

Incomplete left bundle branch block on ECG

LBBB can be caused by damage at various levels:

1. Lesion of the left leg in the trunk of the His bundle;
2. Damage to the main trunk of the left leg before its branching;
3. Simultaneous damage to the anterior and posterior branches of the left leg after their separation from the main trunk of the left leg;
4. Damage to the left half of the interventricular septum involving both branches of the left leg;
5. The presence of pronounced diffuse changes myocardium of the peripheral branches of the anterior and posterior branches of the left leg.

Despite the above options, as a result, with LBBB, excitation cannot pass in the usual way along the left leg to the myocardium of the left ventricle - excitation is carried out in an unusual way.

What causes a slowdown in the passage of excitation through the ventricles, as evidenced by the widening of the QRS complex and a change in the direction of repolarization in the left ventricle:

• in the left precordial leads the QRS complex is represented by a wide tooth RV5, V6 with a notch;
• in the right chest leads, a QRS complex of type rS, QS with wide and deep tooth SV1,V2.

It should be borne in mind that with blockade of the left bundle branch:

1. Excitation stage 1:
   • the left ventricle and the left part of the interventricular septum are not excited;
   • excitation along the right leg is transmitted in the usual way and causes excitation of the right half of the interventricular septum (vector directed to electrode V6);
   • at the same time, excitation of the right ventricle begins (the vector is directed to the V1 electrode);
   • excitation from the right half of the interventricular septum passes to the left and flows slowly;
   • As a result, the total EMF vector is directed to the V6 electrode, since the total thickness of the interventricular septum significantly exceeds the mass of the right ventricle: the beginning of the RV6 wave and the QV1 or rSV1 wave are recorded (this is due to the fact that at the beginning electrical systole the right ventricular vector is close to the V1 electrode, which sometimes allows recording of a small rV1).
2. Excitation stage 2: this is the final excitation of the interventricular septum, flowing from right to left: further descent of the SV1 teeth (QSV1) and rise of RV6 are recorded.
3. Excitation stage 3:
   • caused by excitation of the left ventricle, which follows an unusual path and proceeds slowly;
   • further descent of teeth SV1 (QSV1) and further rise of RV6 are recorded, while on tooth RV6 a notch is usually observed located on the ascending knee (there are several options for explaining this phenomenon, such as;
   • the presence of a short period of time between stages 2 and 3;
   • the predominance of the vector of final excitation of the interventricular septum over the vector of initial excitation of the left ventricle;
   • different interaction between the vector of the interventricular septum and the vector of the left ventricle). Due to the slow spread of excitation, a widening of the QRS complex is noted.
4. The repolarization process begins in the right ventricle and spreads from the epicardium to the endocardium (the vector is directed towards the V1 electrode).

The process of repolarization in the left ventricle is associated with delayed depolarization, and spreads from the endocardium to the epicardium. As a result, the repolarization vector of the left ventricle has the same direction as the right - to electrode V1 (registration of positive TV1, the ST segment in this lead is located above the isoline.

With incomplete blockade of the left leg, excitation may occur, but somewhat slowly. With incomplete RBBB, the QRS complex is shaped like a left bundle branch block, but the QRS width is less than 0.12 s:

• In chest leads V1, V2, the QRS complex has the form rS, QS.
• The STV1,V2 segment can be located on the isoline or above it, the TV1,V2 tooth is usually positive.
• In the chest leads V5, V6, an ECG is recorded that looks like an R wave (qV5, V6 is absent).
• The STV5,V6 segment can be located on the isoline or below it, the TV5,V6 tooth can be of any shape.

In the ECG conclusion, following the nature of the rhythm, the location of the electrical axis of the heart is indicated; give a description of the blockade of the left leg (complete, incomplete); they mention the prolongation of the electrical systole of the ventricles; give a general description of the ECG. If there is simultaneously hypertrophy of the right or left ventricle, then its description is usually given before the general characteristics of the ECG.

Additional diagnostic procedures

Additional measures include:

• Monitoring ECG daily, is necessary to identify a transient form of the disease, manifested in different time days.
• Electrocardiographic studies of the esophagus are necessary for the diagnosis of arrhythmias.
• A cardiac echo is performed to identify organic pathologies in the structure of the heart and to assess the condition of the myocardium.
• MRI is prescribed if controversial issues arise when making a diagnosis.

Electrocardiogram and emission tomography are considered to be the most effective - these research methods make it possible to make an accurate pre-diagnosis and identify the main causes of this cardiac pathology.

Thanks to this diagnostic study it becomes possible to determine the most effective method therapeutic effects.

Therapeutic measures

Treatment of this condition is based on comparison of the results of the cardiogram and ECG with normal indicators heart rate. Since bundle block is not recognized as an independent heart disease, this condition usually accompanies a specific heart disease or several diseases.

Therefore, treatment is necessarily directed primarily at eliminating the root causes of this condition. And the methods of treating primary cardiac damage are determined both by the disease itself and its degree of development, manifestations and general condition of the patient’s body.

The most effective include following methods impacts:

1. If the underlying cause of His bundle block is heart failure, cardiac glycosides will often be prescribed wide range actions, as well as nitroglycerin, antihypertensive drugs that stabilize the heart and its rhythm in the first place;
2. Immune drugs aimed at stimulating the body's defenses and increasing the degree of its resistance to various diseases, including heart diseases.

The most popular today is a broad-spectrum medicine called “Transfer Factor Cardio”: the absence of side effects, a rapid effect on the heart muscle and stimulation of the immune system are the main manifestations of taking the drug;

However, it should be borne in mind that there is no universal therapy for His bundle tissue blocks; The main focus of the therapeutic effect in this case should be considered to be treatment of the underlying disease of the cardiac system with parallel maintenance of the patient’s condition.

This pathology has an unpleasant probable consequence if the main treatment is insufficient: a blockade of this type can progress to a complete blockade of the heart and its atria, which has a poor prognosis for the patient and in this situation requires immediate special medical intervention.

There is no special treatment for patients who experience cardiac conduction disorders. Patients who have been diagnosed with left bundle branch block are not indicated for drug therapy.

Symptomatic treatment of the underlying pathology with one- and two-fascicle blockade includes the following medications:

• Vitamins ( nicotinic acid, thiamine, riboflavin).
• Sedatives (tincture of valerian, motherwort, sage).
• Antioxidants (Preductal, Carnitine).
• Antihypertensive drugs whose action is aimed at treating hypertension (beta-blockers, ACE inhibitors, calcium channel antagonists).
• Antiplatelet agents that prevent blood clots (Aspirin, Cardiomagnyl).
• Medicines used for treatment of ischemic heart disease(Isoket, Nitroglycerin).
• Medicines that normalize blood cholesterol levels (Simvastatin).
• Tablets and injections for the treatment of pathologies that are the root cause of the appearance of cor pulmonale.
• Diuretics (indicated in patients with heart failure).
• Non-hormonal agents and antibiotics for the treatment of inflammation of the myocardial membranes (Diclofenac, Penicillin, etc.)

Surgery for electrical conduction dysfunction involves installing a pacemaker in the patient. Complete blockade (right or left), resulting from an acute infarction, requires temporary stimulation of the myocardium using an electrode.

Three-fascicle blockade, accompanied by attacks of loss of consciousness and a rare rhythm of ventricular contraction, is considered the basis for constant electrical stimulation of the myocardium. The patient is implanted with a cardioverter.

1. A patient who is not bothered by cardiac symptoms and does not suffer from chronic diseases tolerates normal stress-related living conditions well.

Three-bundle and two-bundle blockade will require limited physical activity. Such patients should not work hard and be under stress. Diet and food composition are very important.

To prevent the development of blockades and other cardiovascular pathologies, it is recommended to follow the general rules:

• long sleep;
• active lifestyle;
• lack of self-medication;
• quitting smoking and alcohol;
• balanced nutrition according to the regime;
• elimination of stress and nervous shock;
• regular diagnosis and treatment of heart diseases.

The most common causes of this disease are ischemic disease heart and hypertension. These diseases can appear together or separately. In 77-80% of LBBB they are the cause.

Among other things, left bundle branch block can be caused by:
- aortic valve disease;
- diseases Lenegre, Lev;
- cardiomyopathy;
- myocarditis;
- hyperkalemia;
- neoplasms of the heart;
- dystrophy of the heart muscle.

Sometimes (extremely rarely) left bundle branch block can occur in absolutely healthy people, but it cannot be ruled out that in these cases the heart pathology was very minor and unnoticeable.

There is no specific treatment for this disease, and therapy is limited to treating the underlying disease that is the cause of the left bundle branch block.

But we would like to dwell in more detail on one immune drug, which is today perhaps the most effective means for the prevention and treatment of blockade of the left bundle branch. This Transfer Factor Cardio. The basis of this drug is made up of immune molecules - transfer factors, which, when entering the body, perform the following functions:
- enhance the effect medicines aimed at correcting the functioning of cardio-vascular system and at the same time eliminating all their side effects;
- strengthens the immune system person in relation to a variety of reasons causing heart and vascular diseases :
- being the “immune memory” of the body, the immune particles of the drug “remember” all foreign elements that cause various diseases and when they reappear, identify them and give a command immune system for their destruction.
No other drug has such a “mechanism of action” and that is why immunomodulator TF Cardio today has no analogues in the world in terms of its effectiveness.

Left bundle branch block: prognosis

In this case, the prognosis is worse than with right bundle branch block. Approximately 2% of patients with LBBB develop complete atrioventricular block within 10 years. Left bundle branch block in the setting of acute myocardial infarction increases the possibility of death by 60%.

Average survival with LBBB:
- with a normal heart size - 4.3 years;
- with an enlarged heart - 2.5 years.
Patients usually die suddenly and the main reasons for this are ventricular fibrillation, or ventricular tachycardia.

The prognosis of left bundle branch block is significantly worsened by:
- angina pectoris;
- cardiomegaly;
- heart failure;
- atrial fibrillation;
- myocardial infarction...

B blockade of the left bundle branch is a disruption of the normal conduction of the signal from the sinus node to the ventricle. Hence the decrease in contractility, hemodynamic problems, hypoxia, ischemia and deviations in the functioning of all internal organs.

Because it's not independent disease, you need to look for the root cause. It is possible to restore vital activity and functional activity with sufficient efficiency only with long-term therapy. In extreme cases, surgical intervention is indicated.

The essence of the deviation lies in the disruption of the conduction of an electrical impulse through special fibers.

In the normal state of affairs, the heart is capable of working independently, autonomously, for an indefinitely long period of time. This is ensured by the generation of an electrical impulse in the sinus node (natural pacemaker).

Depending on the degree of blockade, it is divided into partial or complete varieties.
Without the normal movement of the electrical impulse, there can be no contraction.

General forms are characterized by the development of secondary, adaptive mechanisms.

Since the left ventricle does not receive sufficient stimulation from the sinus node, it begins to produce signals on its own.

This does not lead to restoration of functions. Moreover, these are not full cuts. More often it ends in fibrillation. Death in such a scenario, the most likely and obvious.

Classification

Depending on the prevalence of the pathological process:

• One conductive bundle is affected. In most cases, this is exactly the condition that occurs. The general prevalence of blockade of the left leg of His is determined by 1% of the entire population under 40 years of age, after which it is already 3%. The number of situations with minimal fiber involvement is 60%. Symptoms of the condition are completely absent or are so insignificant that they do not attract the patient’s attention. Recovery is likely; fatal complications are rare and occur in best case scenario decades later. Many patients can live until the end of their lives and have no idea that they are suffering from anything.
• Two bundles of the left bundle branch of His are affected. A more dangerous option. Accompanied first by mild and then violent clinical picture. Usually we are talking about organic disorders. Recovery is possible, but it is better to start treatment in the early stages, since there are no gross defects yet.
• Three-bundle block. Relatively rare. Causes fatal complications in most cases. The prospect for the development of such is 1-3 years, in some situations we are talking about months. Treatment is urgent, in a hospital.

According to the degree of disturbance and the nature of the course:

• Intermittent. Registration pathological abnormalities on an ECG is possible. However, the picture is not constant. At one moment a blockade is recorded, at another everything is normal. It is better to determine such “elusive” conditions in a hospital, when there is the possibility of repeated studies, or with the help of a 24-hour Holter monitor.

• Alternating. In this case, there are deviations, but they are also inconsistent. There is a difference. They are always registered, but at each moment of time there are different changes: blockade of one or another bundle. Unstable forms are more difficult to treat; they require special approach. This is why diagnosis is so important.
• Permanent variety. It is characterized by stability of symptoms and clinical, including objective, picture. The relative ease of diagnosis does not make treatment easy.

Based on the nature of the deviation:

• Incomplete blockade of the left bundle branch. Accompanied by a pronounced clinical picture. Despite the severity of the condition, full ventricular contractions are still present because, although to a lesser extent, the signal passes through. There are several clinical variants of the condition. Here the role is played by how many fibers are not involved in the work.
• Complete block of the left bundle branch. The impulse is not transported at all.

These classifications play an important role in practical activities.

Severity

Staging of the pathological process has not been developed with sufficient accuracy. Based on the national recommendations of individual communities, we can talk about four degrees of severity of the blockade:

Causes

Factors in the development of the pathological process are primary diseases that directly cause the blockade, complete or partial.

Among them:

• Calcification. Its essence lies in the disruption of the exchange of salts of the corresponding element. They come out of the bones and are deposited in soft tissues, nerve fibers, leading to generalized disorders of the patient's condition. Damage to cardiac structures is possible and even likely. Calcium blocks the signal. The sources of the problem lie in genetic pathologies, prolonged immobilization, and endocrine diseases.
• Cardiomyopathy. Disruption of the normal formation of muscle structures of the organ. There is a proliferation of myocyte cells, an increase in the size of the heart itself. But this does not add functional activity. It falls in proportion to the changes. There are a group of types of condition, depending on the origin: congenital, toxic and others. Many development factors are potentially controllable and can be influenced as part of prevention.

• Atherosclerosis of the coronary arteries. Leads to disruption of the nutrition of the heart muscle. The result is constant ischemia with the prospect of developing coronary artery disease, and a possible heart attack. Even against the background of incomplete malnutrition, cardiac structures gradually become necrotic. Functionally active tissues are replaced by scar and connective tissues. Hence the acquired myopathy. Blockade is a relatively late complication.

• Inflammatory pathologies of the heart and surrounding structures. Usually infectious in nature. Diseases like myocarditis are aggressive and require urgent hospital treatment with antibiotics. The consequence in 30% of cases is blockade of the anterior branch of the left bundle branch. Other fibers are less commonly affected.

• Heart attack. Advanced variant of coronary insufficiency. It differs from IHD in the avalanche-like nature of its flow. Myocardial tissue becomes necrotic in a matter of hours, and the volume of replacement with scar structures is much more significant. Therefore, the options for the blockade afterward may be different. Usually this is a violation of the conductivity of several bundles, less often the deviation affects the entire leg.

• Hypertension stage 2-3. Usually of the decompensated type, when the blood pressure level is close to 190 to 110-120 mmHg and higher. Leads to constant load on cardiac structures. Deviations are characteristic, usually talking about left ventricular hypertrophy. Tissue proliferation leads to partial blockade(full ones are rare). Recovery represents great difficulties. Supportive therapy.
• , up to complete fusion. Leads to disturbances of local hemodynamics (in the heart). Prompt correction is required before it is too late.

• Congenital and acquired malformations of cardiac structures. Various in type and course. Rarely manifest themselves in a pronounced clinical manner, which complicates early diagnosis pathologies.
• Pulmonary heart. Proliferation of cardiac structures in response to increased pressure in the artery of the same name. Potentially fatal condition.

There are other diseases that would, however, take a long time to list completely.

These include other cardiac and endocrine conditions. AND bad habits like consumption of tobacco, alcohol.

All factors, one way or another, are similar in one thing: blockage of the posterior branch of the left leg of His occurs more often. Slightly less common are other options.

Symptoms of complete LBBB

Characterized by the maximum possible clinical picture. It is considered the most severe type of pathological process.

• Constant arrhythmias. As myocardial contractility decreases, the likely scenario is bradycardia with a beat rate of about 40-50 beats per minute, possibly less. In addition to heart rate disturbances, other abnormalities also occur. Group-type extrasystole often occurs, when the left ventricle begins to produce a signal and contract chaotically on its own.
• Chest pain. Non-specific sign. Characterized by mild discomfort. There are no attacks as such, except for cases of coronary insufficiency.
• Shortness of breath during prolonged physical activity or at rest. Depends on the degree of development of the underlying pathological condition. Severe disability is possible with the inability to even serve oneself at home, not to mention professional activities.
• Weakness, feeling of body weakness, periods of apathy. Included in the picture. They represent general manifestations.
• Paleness of the skin.
• Cyanosis of the nasolabial triangle.
• Sweating, especially at night.
• Mental disorders. Like aggressiveness, irritability, long periods of depression or low emotional levels.
• Fainting. May be repeated over the course of one day.
• Headache.
• Vertigo.
• Impossibility of orientation in space.
• Blood pressure surges.

The clinical picture may vary, depending on the underlying diagnosis and the degree of blockage.

Causes of incomplete LBBB

Occurs more often. In general, everything is limited to the following signs:

• Arrhythmias by type.
• Chest pain.
• Breathing problems.
• Rare syncope (fainting) conditions are possible.

The clinic is minimal, sometimes it is completely absent until the moment when little can be done to help.

How dangerous is the condition?

Possible complications of the process:

• Heart failure. The probability with a complete blockade is 70%. In other situations - proportionally lower. Occurs without preliminary symptoms and requires urgent resuscitation.
• Cardiogenic shock. Generalized hemodynamic disturbances. Mortality is maximum, close to 100%.
• Respiratory failure. Up to asphyxia and death late stages. It is developing rapidly.
• Heart attack. As a result of insufficient nutrition of cardiac structures.
• Dangerous forms of arrhythmia. or extrasystole. Involves cardiac arrest without the possibility of effective recovery.
• Stroke. Acute malnutrition of cerebral tissues with the formation of a severe neurological defect. Death occurs a little less often.

• Multiple organ failure. As a result of hemodynamic disturbances general type. The liver and kidneys suffer. The brain is not the least important.

With a significant volume of violations, the risk increases vascular dementia- a sharp, gross weakening of mnestic and cognitive functions.

Diagnostics

It is carried out under the supervision of a cardiologist. In inpatient or outpatient settings, depending on the patient’s condition.

Approximate list of events:

• Listening to patient complaints about health. Recording for further analysis
• Anamnesis collection. The presence of current or previously suffered pathologies of the cardiac type plays a huge role.
• Blood pressure measurement. Against the background of the blockade, it is consistently high, this is a compensatory mechanism. Also heart rate. Bradycardia with an irregular rhythm is characteristic.
• Listening to heart sounds (auscultation).
• Electrocardiography. Basic technique. Left bundle branch block has specific symptoms.
• Daily monitoring using an automatic tonometer. Used to clarify the process. Especially against the background of an alternating type of deviation. Also if the blockade alternates with periods of spontaneous normalization.
• Echocardiography. To assess the degree of organic disorders.
• MRI. To obtain detailed images of cardiac structures. Required in controversial cases to identify the origin of the process.
• General blood test.

Controversial cases require extensive examination under the supervision of several specialists.

Signs of left bundle branch block on ECG

Full:

• Widening of the QRS complex (> 0.11 sec), splitting, notching.
• R peak deformation.
• ST depression.
• Negative T wave.
• S is missing.
• Slow down the rhythm to 40-60 beats per minute.

There are other typical features. These are the most typical. Without special training, it will not be possible to decipher a cardiogram.

Incomplete:

• QRS deformation.
• R, S vertex splitting.
• Absence of Q in leads V5-6.

Signs of left bundle branch block on an ECG are determined relatively easily by a cardiologist.

Treatment

Therapy is carried out in two ways:

1. Elimination of the main cause of the pathological condition. The etiotropic technique is aimed at preventing further development and aggravation.
2. Relief of symptoms. To normalize the quality of life, reduce the risks of complications in the short term.

In the first direction, the underlying disease is eliminated. Depending on the diagnosis, we may be talking about the use of medications or surgery.

Surgery is required in a limited number of cases: heart defects, including abnormalities in the development of the mitral valve, the need to install a pacemaker, or prosthetics.

Symptomatic therapy consists of the use of medications, Surgically getting rid of the blockade as such will not work.

The following groups of drugs are prescribed:

• Cardiac glycosides. Lily of the valley tincture, Digoxin and others. In minimal dosages to maintain the contractility of the muscle layer.
• Organic nitrates for the relief of acute attacks of arrhythmia or pain.
• Diuretics to normalize fluid removal and prevent congestive heart failure.
• Antihypertensive drugs (ACE inhibitors mainly).

As necessary, thrombolytics, statins, and antiarrhythmics are prescribed in small quantities.

Lifestyle changes can only play a role if the underlying pathological process is determined by addictions.

Application folk recipes will have no effect. It is not recommended to waste time on dubious grandma’s methods. Every day counts.

Forecast

With complete blockade- serious. Complications occur several months or years after diagnosis. Death is the most likely outcome. It is determined in 70% of cases against the background of cardiac arrest.

With incomplete everything is somewhat better. The median survival rate is 5-7 years, with a competent course of therapy the period is indefinitely long.

In any case, treatment improves prognosis. It is difficult to say in advance what awaits the patient; you need to observe for some time before drawing conclusions.

Finally

Left bundle branch block is potentially more dangerous and lethal than right branch block because the left ventricle is affected.

Treating the condition itself is almost pointless. The root cause needs to be identified.

Etiotropic and symptomatic effects are indicated simultaneously to obtain best result. All issues are resolved in person in consultation with a cardiologist. Self-indulgence is strictly prohibited if the patient values ​​his life.