Right bundle-branch block. Occurrence following nonpenetrating chest trauma without evidence of cardiac contusion

RIGHT bundle-branch block (RBBB) is an unusual complication of non-penetrating trauma to the chest. Rankin and Patterson1in 1952 and Parmley et al2in 1958 described transient intraventricular conduction defects that they concluded were due to myocardial contusion. We report a case of transient RBBB that developed following nonpenetrating chest trauma without myocardial injury as evidenced by serial ECGs, technetium Tc 99m pyrophosphate scan, and cardiac enzyme values. Report of a Case A 55-year-old man who had been previously healthy was seen in the emergency room of the Houston Veterans Administration Hospital following an automobile accident in which he had sustained blunt trauma to the anterior chest wall. His only complaint was of nonradiating pleuritic chest pain. The patient was in mild distress. The cardiac apical impulse was in the sixth intercostal space of the midclavicular line. His pain increased following firm palpation of the anterior chest wall. Otherwise,