Key result
Acute pulmonary embolism in a 61-year-old man with pre-existing left bundle branch block resulted in the transient disappearance of the LBBB pattern on ECG.
Case Report (n=1)
Acute pulmonary embolism can present with the unusual ECG finding of transient disappearance of a pre-existing left bundle branch block pattern.
Transient LBBB resolution in acute PE merits clinical recognition; one case leaves mechanism and frequency open.
A 61 year old man developed acute pulmonary embolism while in hospital. His previous and admission electrocardiograms (ECGs) showed a typical left bundle branch block (LBBB) pattern. Immediately after the onset of acute pulmonary embolism, LBBB disappeared from his body surface ECG with sinus bradycardia, normalisation of QRS duration, prolonged QT interval, and marked T abnormalities to the right precordial leads. Recovery from pulmonary embolism resulted in reappearance of his left bundle branch pattern. Delayed conduction of the previously unaffected right bundle branch resulting in roughly equivalent onset of ventricular activation is the most likely reason. Rate dependent LBBB is also discussed.
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Athar et al. (2002) conducted a case report in Acute pulmonary embolism (n=1). Acute pulmonary embolism was evaluated on ECG changes (transient disappearance of LBBB pattern). Acute pulmonary embolism in a 61-year-old man with pre-existing left bundle branch block resulted in the transient disappearance of the LBBB pattern on ECG.
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