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How To Rule Out Bundle Branch Block?

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Posted on Tue, 24 Nov 2015
Question: I am fearful of undergoing a pharmacologic/nuclear stress test that is scheduled due to EKG finding of left bundle branch blockage. Can you tell me about the test and about my diagnosis?
Thank you
doctor
Answered by Dr. Dr. Meriton Siqeca (30 minutes later)
Brief Answer:
Not to worry about

Detailed Answer:
Greetings, madame. Welcome to Health Care Magic and thank you for your question. I understand your concern.

Lots of people undergo a nuclear stress test. It is especially indicated when there is a bundle branch block present in EKG, and conventional, physical cardiac stress test cannot be performed. The reason is that during cardiac stress test on treadmill, ST segment of the EKG is evaluated to confirm or exclude a probable coronary artery disease. This segment is modified in cases with bundle branch block, therefore the conventional cardiac stress test would be mute and non-conclusive. This is the reason why nuclear/pharmacological stress test is indicated. LBBB (left bundle branch block) may be congenital, due to myocardial infarction (if new) and is often present in subjects with heart failure due to enlarged heart (dilated cardiomyopathy). Whatever the case, this test is recommended to be performed to evaluate the viable myocardial (cardiac muscle) tissue and whether there is ischemia (suffering of the heart muscle) or not. Depending on the test results, coronary angiogram may be suggested.

As for the claustrophobia, there are a lot of claustrophobic people that undergo this procedure and they do fine. It is only when severely claustrophobic, that pharmacological measures with sedatives, are undertaken before the procedure. My opinion is that you will do just fine.

I hope I was helpful with my answer. I am happy to help, if you have follow up questions. Please rate the answer, if you do not. Good luck with the procedure.

Best regards,
Dr. Meriton
Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. Dr. Meriton Siqeca (2 hours later)
I have read that the side effects of the Lexiscan are chest discomfort, shortness of breath, extreme warmth. How do I know whether I am feeling the expected discomfort or am in dangerous distress? Thank you for your answer and your good wishes.
doctor
Answered by Dr. Dr. Meriton Siqeca (4 hours later)
Brief Answer:
Welcome back

Detailed Answer:
Hello again.

Yes, Lexiscan and Adenoscan, although not often, can cause side effects, but they are temporary, in general. They are approved agents for the scan, and the scan cannot be performed without using them. I would recommend you not to worry about the side effects of the agent, knowing that this scan is done for more important purposes - confirming or excluding a probable coronary artery disease. For analogy, it is the same with iodine contrast agent used for angiogram or CT of coronary arteries. It also can produce various side effects, which we always take into consideration, and we are prepared to suppress/treat them, should they appear before/during/after the examination. Every medical decision-making is based on a careful weighing of benefits against risks and this is our everyday job.

I hope I have been of help. Wish you a good health.

Best regards,
Dr. Meriton
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Sonia Raina
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Answered by
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Dr. Dr. Meriton Siqeca

Cardiologist

Practicing since :2009

Answered : 775 Questions

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How To Rule Out Bundle Branch Block?

Brief Answer: Not to worry about Detailed Answer: Greetings, madame. Welcome to Health Care Magic and thank you for your question. I understand your concern. Lots of people undergo a nuclear stress test. It is especially indicated when there is a bundle branch block present in EKG, and conventional, physical cardiac stress test cannot be performed. The reason is that during cardiac stress test on treadmill, ST segment of the EKG is evaluated to confirm or exclude a probable coronary artery disease. This segment is modified in cases with bundle branch block, therefore the conventional cardiac stress test would be mute and non-conclusive. This is the reason why nuclear/pharmacological stress test is indicated. LBBB (left bundle branch block) may be congenital, due to myocardial infarction (if new) and is often present in subjects with heart failure due to enlarged heart (dilated cardiomyopathy). Whatever the case, this test is recommended to be performed to evaluate the viable myocardial (cardiac muscle) tissue and whether there is ischemia (suffering of the heart muscle) or not. Depending on the test results, coronary angiogram may be suggested. As for the claustrophobia, there are a lot of claustrophobic people that undergo this procedure and they do fine. It is only when severely claustrophobic, that pharmacological measures with sedatives, are undertaken before the procedure. My opinion is that you will do just fine. I hope I was helpful with my answer. I am happy to help, if you have follow up questions. Please rate the answer, if you do not. Good luck with the procedure. Best regards, Dr. Meriton