What question did this study set out to answer?

To correlate sequential electrocardiographic conduction abnormalities, specifically left anterior hemiblock followed by complete right bundle branch block, with coronary angiographic findings to assist prognostic evaluation.

May 27, 2025Russian Journal of Preventive Medicine

Manifestation of stenosis of the anterior interventricular branch of the left coronary artery: the Hiss beam legs blockade

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Why the study?

Complete right bundle branch block can indicate a worsening prognosis, prompting comparison of sequential left anterior hemiblock and complete right bundle branch block with coronary angiography findings.

Population

One 53-year-old patient without anginal pain

Design

Clinical case report

Authors

СЧС. А. ЧепурненкоRostov State Medical University ГШГ. В. ШавкутаRostov State Medical University MCM.S. ChepurnenkoRostov State Medical University

Discussion

Member takes

Implication

Sequential ECG progression may flag coronary risk; leaves open validation for routine prognostication.

Key Points

To correlate sequential electrocardiographic conduction abnormalities, specifically left anterior hemiblock followed by complete right bundle branch block, with coronary angiographic findings to assist prognostic evaluation.
Evaluated a 53-year-old patient presenting without anginal pain but with multiple cardiovascular risk factors, including hypertension, diabetes mellitus, gouty arthritis, a 20-year smoking history, and physical inactivity.
Tracked serial electrocardiograms from September 2020 to June 2024 and performed invasive coronary angiography to inspect coronary anatomy corresponding to conduction system changes.
Electrocardiography revealed progressive intraventricular conduction impairment, evolving from initial left anterior hemiblock to complete right bundle branch block, with QRS widening increasing from 0.16 mm to 0.20 mm.
Coronary angiography demonstrated an isolated 80% stenosis at the ostium of the left anterior descending artery, which was treated with percutaneous stenting.

Structured PICO

Population

1 53-year-old patient without anginal pain presenting with sequential left anterior hemiblock and complete right bundle branch block, with hypertension, diabetes mellitus, gouty arthritis, 20 years history of smoking, and a sedentary lifestyle.

Intervention

Coronary angiography and left anterior descending artery (LADA) stenting

Outcome

Identification of coronary artery stenosis on angiographysurrogate

The sequential development of left anterior hemiblock and complete right bundle branch block may indicate significant stenosis of the left anterior descending artery, warranting invasive coronary angiography even in the absence of anginal pain.

Cite This Study

Чепурненко et al. (2025) studied this question.

synapsesocial.com/papers/6a8962080e4958e0bcf7c2b2 https://doi.org/10.17116/profmed20252805196

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Manifestation of stenosis of the anterior interventricular branch of the left coronary artery: the Hiss beam legs blockade

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Manifestation of stenosis of the anterior interventricular branch of the left coronary artery: the Hiss beam legs blockade

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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