Key result
Coronary revascularization of a ramus intermedius occlusion resolves transient LBBB and improves LV systolic function.
Case Report (n=1)
No
This case highlights an unusual presentation of transient LBBB and acute heart failure caused by a ramus intermedius occlusion, which successfully resolved following coronary revascularization.
Caution against changing LBBB management based on one case; leaves open whether ramus occlusion can cause reversible conduction disease.
We present a case of acute decompensated heart failure due to transient left bundle branch block (LBBB) as a consequence of a ramus intermedius (RI) occlusion. A 63-year-old woman was admitted with acute onset of typical chest pain and pulmonary edema, a newly diagnosed LBBB and left ventricular (LV) systolic dysfunction. A coronary angiogram demonstrated critical stenosis at the osteal segment of RI. After successful coronary revascularization, LBBB was completely resolved, with an improvement in LV systolic function and symptoms. In terms of anatomical blood supply of the left bundle branch, transient LBBB as a consequence of an RI occlusion is unusual.
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Eren et al. (2024) conducted a case report in Acute decompensated heart failure, transient LBBB, ramus intermedius occlusion (n=1). Coronary revascularization was evaluated on Resolution of LBBB and improvement in LV systolic function and symptoms. Coronary revascularization of a critical ramus intermedius occlusion completely resolved transient left bundle branch block and improved left ventricular systolic function in a 63-year-old woman.
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