Bundle Branch Block: Right and Left Prognosis Implications

An increasing number of papers, most based on epidemiology, have shown a strong association between bundle branch block (BBB) and cardiovascular disease, more specifically hypertension, cardiomegaly, coronary artery disease, and heart failure. Left BBB (LBBB) has been associated with cardiovascular disease complications in a much larger number of cases if compared to Right BBB (RBBB). RBBB is usually associated to benign findings in healthy and asymptomatic individuals; nevertheless it can indicate affection of the right side of the heart through cor pulmonale, myocardial ischemia/infarction, pulmonary embolism, myocarditis, or congenital heart disease. LBBB and RBBB prognosis strength are taking new positions over the time. Both have shown its relation with patient’s mortality and prognosis implications. Therefore, in this review, we intend to make an approach of the BBB and its prognosis relevance based on the latest studies about this role. Physicians should keep their patients with heart failure, myocardial infarction, and other abnormalities associated with BBB, under watch. Even the asymptomatic ones with coronary risk factors, should be carefully followed, once they have been associated with an increased mortality if compared with those who are not affected by bundle branch blocks.