Branch block

Description

Bundle branch block is a condition in which there is a delay or obstruction along the pathway that electrical impulses travel to make your heart beat. It sometimes makes it more difficult for the heart to pump blood to the rest of the body.

The delay or blockage can occur on the pathway that sends electrical impulses either to the left or to the right of the lower chambers (the ventricles) of the heart.

Bundle branch block might not need treatment. When it does, treatment involves managing the underlying health conditions, such as heart disease, a disease that is caused branch block.

Symptoms

In most people, bundle branch block doesn't cause symptoms. Some people with the condition do not know they have a bundle branch block.

Rarely, the symptoms of bundle branch block may include fainting (syncope), or the feeling as if you're going to faint (presyncope).

When to see a doctor

If you've fainted, consult a doctor to rule out serious causes.

If you have heart disease or who have been diagnosed with bundle branch block, ask your doctor how often you should have follow-up visits.

Causes

The electrical impulses in the muscle of the heart causes it to beat (contract). These impulses travel along a pathway, including two branches called the right and left bundles. If one or both of these branch bundles are damaged due to a heart attack, for example — the electrical impulses may be blocked. As a result, the heart beats irregularly.

The cause for the branch of the blocks can vary depending on whether the left or the right branch is affected. Sometimes, the cause is not known.

The causes may include:

Left bundle branch block

  • Heart attack (myocardial infarction)
  • High blood pressure (hypertension)
  • Inflammation of the heart muscle (myocarditis)
  • Thick, stiff, or weakness of the heart muscle (cardiomyopathy)

Right bundle branch block

  • Blood clot in the lungs (pulmonary embolism)
  • Heart attack (myocardial infarction)
  • Structure of the heart problems that are present at birth (congenital heart defects) — like a hole in the wall that separates the upper chambers of the heart (atrial septal defect)
  • High blood pressure in the pulmonary arteries (pulmonary hypertension)
  • Inflammation of the heart muscle (myocarditis)

Risk factors

Risk factors for branch block are:

  • The increase of the age. Bundle branch block is more common in older adults than in younger people.
  • Underlying health problems. Having high blood pressure or heart disease increases the risk of having bundle branch block.

Complications

If the right and to the left packages are locked in, the main complication is a complete blockage of the electrical signaling of the upper part of the lower chambers of the heart. The lack of signage can decrease the heart rate. A slow heart rate can lead to fainting, irregular heart rhythms and other serious complications.

Due to bundle branch block affects the electrical activity of the heart, which can sometimes complicate the accurate diagnosis of other heart conditions, particularly heart attacks. It can lead to a delay in proper management of the diseases of the heart.

Branch block

Diagnosis

If you have a right bundle branch block and you feel healthy, you might not need a full medical check-up. If you have a left bundle branch block, you will need a complete medical examination.

Tests that can be used to diagnose a bundle branch block or its causes include:

  • Electrocardiogram (ECG or EKG). This quick and painless test that measures the electrical activity of the heart. During an ECG, sensors (electrodes) are attached to the chest and, at times, the arms or the legs. One can show how well the heart is beating. May show signs of a bundle branch block, as well as which side of the heart is affected.
  • The echocardiogram. This test uses sound waves to provide detailed images of the heart and heart valves. They can show the structure and the thickness of the heart muscle. Your doctor can use this test to identify a condition that caused the branch block.

Treatment

Most people with bundle branch block does not have symptoms and do not need treatment. For example, left bundle branch block is not treated with medications. However, the treatment depends on the specific symptoms and other conditions of the heart.

Drugs

If you have a heart condition causing bundle branch block, treatment may involve medications to reduce high blood pressure, or reduce the symptoms of heart failure.

Surgeries and other procedures

If you have bundle branch block and a history of fainting, your health care provider may recommend a pacemaker. A pacemaker is a small device that is implanted under the skin of the upper part of the chest. Two wires connect with the right side of the heart. The pacemaker releases electrical impulses when necessary to keep the heart beating regularly.

If you have bundle branch block with low heart pumping function, you may need to cardiac resynchronization therapy (biventricular pacing). This treatment is similar to having a pacemaker implanted. But you're going to have a third wire is connected on the left side of your heart, so that the device can keep both sides at the correct pace. Cardiac resynchronization therapy help of the chambers of the heart contract in a more organized and efficient.

Preparing for your appointment

It is likely to start by seeing your primary care physician. You may be referred to a doctor trained in heart conditions (cardiologist).

Here's some information to help you prepare for your appointment.

What you can do

Be aware of pre-appointment restrictions. When you make the appointment, ask if there is something that you need to do beforehand. For example, it may be necessary to limit or avoid the consumption of caffeine before you have the heart function tests.

Make a list of:

  • Your symptoms, including any that seem unrelated to the reason for which you scheduled the appointment, when they started and how often they occur
  • Key personal information, including major stresses or recent life changes
  • All the drugs, vitamins, and supplements you are taking, including dose
  • Questions to ask your health care provider

Ask a family member or friend to come with you, if possible, to help you remember the information that you receive.

For the bundle-branch block, questions to ask your provider include:

  • What are the most likely causes of my symptoms?
  • What tests do I need?
  • What treatments are available, and which do you recommend?
  • Does the branch block return after treatment?
  • What side effects can I expect from treatment?
  • I have other health conditions. How can I best manage them together?
  • Do you have brochures or other printed material I can have? What sites do you recommend?

What to expect from your doctor

Your health care provider is likely to ask questions such as:

  • Nothing seems to improve the symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Has a health care provider has told you that you have a bundle branch block?
Symptoms and treatment of bundle branch block