Unmasking a Hidden Bridge: Exercise‐Induced Right Bundle Branch Block Without Ischemia

Figures

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  Figure 1. Baseline electrocardiogram: Baseline electrocardiogram showing ventricular extrasystole (arrow).

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  Figure 2. Exercise stress test electrocardiogram: Twelve lead electrocardiogram obtained during the maximal exertion, demonstrating an incomplete right bundle branch block.

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  Figure 3. (a) Three‐dimensional volume reconstruction of the heart and coronary arteries. Multiple three‐dimensional volume rendered images obtained from coronary computed tomography angiography illustrating the intramyocardial course of the mid‐segment of the LAD. The vessel is traversing beneath a thin layer of myocardial fibers before returning to the epicardial surface distally. (b) 2D‐curved multiplanar reformation images. In the mid‐segment of the LAD coursing intramyocardially, a myocardial bridging is observed (arrows). No evidence of luminal narrowing or atherosclerotic involvement is seen in the bridged or adjacent segments of the LAD.