CLINACASE

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ID: 162
Category: Heart condition
CreatedBy: 1
UpdatedBy: 1
createdon: 13 Feb 2023
updatedon: 13 May 2023

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Author: Khoa Tran
Published Feb 13, 2023
Updated May 13, 2023

Table of contents

Bundle Branch Block

History of Bundle Branch Block

In 1895, William Harvey did experiments and saw that if a certain group of cells in the heart was destroyed, it could cause a type of heart problem called atrio-ventricular block.

In 1905, J. Erlanger did experiments on animals and found that he could cause either a partial or complete heart block by changing the pressure on this group of cells, which is called the "bundle of His" (BH). He also saw damage to this group of cells in these animals.

In 1909, H. Eppinger and C.J. Rothberger did experiments on dogs and saw that injecting silver nitrate into certain parts of the heart caused changes in the heart's electrical signals.

In 1910, Eppinger and Rothberger found that if they cut both branches of the bundle of His (BH), that it caused complete heart block.

In 1914, Thomas Lewis and Alfred Cohn used electrocardiogram to measure a patient's heart's electrical signals and found that the patient's heart had old inflammatory lesions that damaged part of the bundle of His (BH), causing a type of heart block. This was possible because technology had improved, allowing doctors to measure the heart's electrical signals more accurately.

Currently, doctors also used a technique called catheterization to directly measure the heart's electrical signals by inserting a small electrode into the heart. This allowed them to diagnose bundle branch block more accurately and develop better treatments for the condition.

Modern Understanding of Bundle Branch Block

Bundle branch block (BBB) is a type of heart block, a condition in which the electrical signals that control the heart's rhythm are slowed or disrupted. While bundle branch block itself does not typically cause any symptoms, it may be associated with underlying heart problems that can cause symptoms.

Causes of Bundle Branch Block

- Coronary artery disease: when the arteries that supply blood to the heart become narrowed or blocked, it can affect the electrical signals in the heart.
- Cardiomyopathy: a disease that affects the heart muscle can lead to changes in the electrical signals that cause BBB.
- Congenital heart defects: some people are born with structural abnormalities in their heart that can lead to BBB.
- Aging: as we age, the electrical system of the heart can stop working properly, leading to BBB.
- Infections: certain infections can damage the heart muscle and disrupt the electrical signals.
- Medications: some medications, such as beta blockers or calcium channel blockers, can affect the electrical system of the heart.
- High blood pressure: hypertension can put stress on the heart and contribute to BBB.

It is important to note that in some cases, the cause of BBB may not be known. If you experience symptoms of BBB, such as shortness of breath or chest pain, it is important to seek medical attention right away.

Treatments for Bundle Branch Block

Bundle branch block is a condition where there is a delay or blockage in the electrical impulses that control the heartbeat within the heart's ventricles. Treatment for bundle branch block depends on the severity of symptoms, underlying heart conditions, and the risk of complications.

If the bundle branch block is mild, a person may not require any treatment. However, if the bundle branch block is leading to symptoms like dizziness, fainting, palpitations, shortness of breath, or chest pain, the doctor may recommend treating the underlying condition that is causing the blockage.

The treatment usually involves managing the underlying heart condition, such as high blood pressure, coronary artery disease, heart failure or valve disease. The doctor may prescribe medications like beta-blockers, calcium channel blockers, or ACE inhibitors to regulate the heartbeat and control blood pressure.

In some cases, a pacemaker may be recommended to regulate the heart's rhythm. A pacemaker is a small device that is inserted under the skin in the chest and connected to the heart with wires. The pacemaker sends electrical impulses to the heart, helping it to beat regularly.

If left untreated, bundle branch block may lead to complications like heart failure, arrhythmias, and other serious heart conditions. Therefore, it is important to receive proper diagnosis and treatment as soon as possible.

Lifestyle Changes

- Quit smoking: Smoking can cause damage to the heart and blood vessels, which can worsen BBB. Quitting smoking can help reduce the risk of further damage and improve heart health.
- Manage blood pressure and cholesterol: High blood pressure and high cholesterol can put a strain on the heart and make BBB worse. Eating a heart-healthy diet, exercising regularly, and taking medication as prescribed can help manage these conditions.
- Exercise regularly: Regular exercise can help improve heart health, lower blood pressure, and reduce stress. However, people with BBB should talk to their doctor before starting any exercise program.
- Maintain a healthy weight: Being overweight or obese can put extra strain on the heart and worsen BBB. Maintaining a healthy weight through diet and exercise can help improve heart health.
- Manage stress: Stress can raise blood pressure and make BBB worse. Finding ways to manage stress, such as through meditation, yoga, or therapy, can help improve heart health.

It's important to note that these lifestyle changes should be done in conjunction with any medical treatment prescribed by a doctor. People with BBB should talk to their doctor before making any changes to their lifestyle or treatment plan.

Nutrional Changes

There are no specific dietary changes that have been proven to treat or prevent bundle branch block. However, following a healthy and balanced diet can promote overall heart health and reduce the risk of developing heart disease, which is a common underlying cause of bundle branch block. A heart-healthy diet may include:

- Eating plenty of fruits and vegetables
- Consuming lean protein sources, such as poultry, fish, and legumes
- Reducing salt intake to control high blood pressure
- Limiting processed and sugary foods and drinks
- Consuming moderate amounts of alcohol or avoiding it altogether
- Staying hydrated by drinking plenty of water

It is important to consult with a healthcare professional or a registered dietitian for personalized dietary advice based on individual health needs and medical history.

Symptoms

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Irregular heartbeat
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Swelling in the legs, ankles, feet, or face (edema)
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Chest pain
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Shortness of breath
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Fatigue
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Fainting / loss of consciousness

Confirmation Tests

- Echocardiogram
- Electrocardiogram (ECG)

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