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(Chest. 1974;66:583-585.)
© 1974 American College of Chest Physicians

Bifascicular Block Related to Anginal Episodes

Prem K. Gupta M.D.1; Edgar Lichstein M.D.1; and Kul Chadda M.D.1

1 Department of Medicine, Division of Cardiology, Mount Sinai Hospital Services, City Hospital Center at Elmhurst, Mount Sinai School of Medicine of the City University of New York, Elmhurst

A patient is presented who showed intermittent right bundle branch block and left posterior hemiblock related to anginal episodes. This occurred several days after an acute myocardial infarction. At no time did the patient develop complete A-V block. His bundle electrograms recorded during normal intraventricular conduction and during the bifascicular block showed a prolonged His-Purkinje conduction time. A rate-related phenomena was excluded since no change in heart rate was noted with the appearance of bifascicular block. The occurrence of this unusual conduction abnormality with angina suggests that diminished blood supply to an already diseased conduction system is the probable mechanism.






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Copyright © 1974 by the American College of Chest Physicians.