Clinical and Echocardiographic Evaluation in Patients with Newly Detected Right Bundle Branch Block

BACKGROUND bundle branch block in the ECG is often incidentally detected during routine evaluation. It can occur as a normal variant or in association with disorders. Evaluation of patients with incidental detection of RBBB ECG may give information regarding the clinical relevance of this abnormality. 100 consecutive patients without previously known cardiac disease attending outpatient department whose ECG showed a right bundle branch block with a QRS width >100 msec were included in the study. After detailed evaluation including history and physical examination, these patients were to echocardiographic evaluation in the standard transthoracic windows Philips Envisor Colour Doppler Echocardiography machine. Two dimensional M-mode examination and colour Doppler echocardiographic evaluation were out, specifically looking for any structural abnormalities of the heart. evaluation revealed structurally normal heart in 74% patients. 26% had cardiac involvement which was either primary or secondary. 62% had right heart disease, either congenital or acquired. Congenital heart was observed in 11% cases- atrial septal defect in 9%, patent foramen in 1% and Ebstein’s anomaly in 2%. Other associations were idiopathic cardiomyopathy in 4%, rheumatic heart disease in 2%, degenerative aortic disease in 2%, and pericardial effusion in 2% cases. study underscores the importance of echocardiographic evaluation to identify structural heart disease in patients presenting with RBBB in the ECG.