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Suggest Treatment For Chronic Left Bundle Branch Block
Question: Thank you. I have 2 questions. The first is: Which medications, if any, can cause a transient Left Bundle Block to appear on an ECG?
The second question is: Which medications, if any, lower diastolic blood pressure without lowering systolic blood pressure?
(For both answers, I would appreciate some references.)
Thank you very much.
kKVF
The second question is: Which medications, if any, lower diastolic blood pressure without lowering systolic blood pressure?
(For both answers, I would appreciate some references.)
Thank you very much.
kKVF
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello,
Welcome on HCM!
Regarding your concern, I would explain as follows:
- In general, transient or chronic (whichever it be) left bundle branch block (LBBB) is a marker of at least four cardiac conditions (coronary artery disease, hypertensive heart disease, aortic valve disease, and cardiomyopathy).
Transient LBBB may be also seen in the settings of an extreme tachycardia (even when medically induced in EP lab).
But in rare cases also some drugs like antiarrhythmics may be associated with widening of QRS complex and transient appearance of LBBB. (You can also consult medical literature, like: Cardiac Electrophysiology: From Cell to Bedside, XXXXXXX P. Zipes, etc).
- Regarding high blood pressure management, I would explain tha almost all antihypetensive drug classes exert to some degree their lowering effect in both systolic and diastolic BP values.
You should know that at age less than 50 the diastolic is the most important predictor of adverse outcome.
At age 50-59 systolic pressure takes over as the most important predictor.
At 60 and over, the pulse pressure is the greatest predictor in this regard.
So it depends on the age to chose the best strategy in controlling hypertension.
Nevertheless, drugs like thiazide diuretics, ACEI and beta-blockers may play an important role in controlling diastolic blood pressure (remember they also affect systolic component as well) (You can also consult medical literature like Evidence-Based Guideline for the Management of High Blood Pressure in Adults [JNC 8]).
Hope to have been helpful to you!
Feel free to ask me again whenever you need!
Greetings!
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello,
Welcome on HCM!
Regarding your concern, I would explain as follows:
- In general, transient or chronic (whichever it be) left bundle branch block (LBBB) is a marker of at least four cardiac conditions (coronary artery disease, hypertensive heart disease, aortic valve disease, and cardiomyopathy).
Transient LBBB may be also seen in the settings of an extreme tachycardia (even when medically induced in EP lab).
But in rare cases also some drugs like antiarrhythmics may be associated with widening of QRS complex and transient appearance of LBBB. (You can also consult medical literature, like: Cardiac Electrophysiology: From Cell to Bedside, XXXXXXX P. Zipes, etc).
- Regarding high blood pressure management, I would explain tha almost all antihypetensive drug classes exert to some degree their lowering effect in both systolic and diastolic BP values.
You should know that at age less than 50 the diastolic is the most important predictor of adverse outcome.
At age 50-59 systolic pressure takes over as the most important predictor.
At 60 and over, the pulse pressure is the greatest predictor in this regard.
So it depends on the age to chose the best strategy in controlling hypertension.
Nevertheless, drugs like thiazide diuretics, ACEI and beta-blockers may play an important role in controlling diastolic blood pressure (remember they also affect systolic component as well) (You can also consult medical literature like Evidence-Based Guideline for the Management of High Blood Pressure in Adults [JNC 8]).
Hope to have been helpful to you!
Feel free to ask me again whenever you need!
Greetings!
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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