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Is right bundle branch block related to kidney problem?

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Cardiologist, Interventional
Practicing since : 1996
Answered : 192 Questions
I have just been told my EKG shows RBBB, my blood work is all normal.I have frequent UTIs past EKG never showed this RBBB. Can RBBB just show up at age 58 or can it be related to a kidney problem?
Posted Sun, 29 Apr 2012 in Valvular Heart Disease
Answered by Dr. Raja Sekhar Varma 5 hours later

Thank you for your health query.

Can RBBB show up at age 58? Yes, it can.

Can it be related to a kidney problem? Simple UTI is usually not associated with RBBB. However, if there is any decline in kidney function with associated electrolyte abnormalities, hypercalcemia, and hypertension, yes, these can lead to RBBB. This may be reversible, sometimes; and when the abnormalities are set right, conduction of the heart may improve.

A very general information as I give here:

RBBB stands for Right Bundle Branch Block. The heart muscle normally pumps blood in a co-ordinated fashion. The co-ordinated pumping is triggered and regulated by specialized electrical activity which spreads across the heart via specialised conducting system. One such major branch of the electrical conducting system is the right bundle branch. When there is slowing of conduction or complete blockage of conduction, the ECG shows features of RBBB.

The prevalence of RBBB increases with age. There are many causes for this condition including age-related degenerative changes in the conduction tissue, ischemic heart disease, inflammations of the cardiac muscle, cardiomyopathy, any disease that puts a stress on the right ventricle leading to dilatation of the right atrium/ventricle including pulmonary embolism, like Brugada syndrome, etc. RBBB can also be seen sometimes in normal people. Sometimes, the block may be incomplete and conduction improves with slowing of the heart rate. Sometimes, the block may be functional and at other times, the block may be structural and complete.

Once there is RBBB pattern in the ECG, there are some other parameters in the ECG that you should check. What is the QRS axis? Is the PR interval normal? If there are problems with these, then it is possible that other parts of the conduction system too have some disease. Next, are there any other signs of chamber enlargement in the ECG? Is there any evidence of ischemia?

So further work-up is indicated at this stage for you to look for any of the causes of RBBB. These may include an echocardiogram, chest X-ray plus other tests as your treating doctor deems fit.

The treatment of RBBB is directed at the cause found. If it is isolated RBBB, usually only follow-up is required.

I hope this answers your query. Feel free to contact me again for any further clarifications
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