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Heart Disease (Expert Forum)
Incomplete Right Bundle Branch Block
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Incomplete Right Bundle Branch Block
by LukeL, Mar 09, 2006 12:00AM
Had run of palpitations one year ago had 3 EKGs, Echo, and 2 ER visits and was on 3 lead telemetry during my stay. Only significant finding was an IRBBB on the EKGs and catching a couple of palps on telemetry which apparently caused no alarm as no doctor or nurse came in to check on me.
Since that stay I have had two periods of having blured vision both during high stress periods. I have also woken up twice and had what I could best describe as blackened vision right in front of me, which only got better after repeated blinking. During this time I didn't have any other symptoms.
Curently on 25mg Toprol XL 2X daily, 2.5mg Diazapem 2X daily (tapering off) and 10mg Paxil daily.
For the longest time I have had an irrartional fear of sleep and since reading about Brugada syndrome it has gotten worse. I am abel to convice myself I don't have any cardiac condtion but Brugada.
1.Would the typical Brugada EKG be obvious to a doctor or could it be easily overlooked?
2. I have a flat chest and thin chest wall and very little pectoral muscles could this cause a false positive with the IRBBB.
3. No history of any cardiac problems in my family and all relatives are alive or lived passed the age of 80 does this lowed the risk of an EP condition?
4.Are vision disturbances common upon wakening? I also have sleep paralysis could the vision problems be a manifestation of that?
5. So far at least 2 cardiologist and 3 internist have looked at my EKGs should I stop worrying?
I am a 21 year old male 5'6 120lbs and in otherwise good health.
Thank you for your time.
Since that stay I have had two periods of having blured vision both during high stress periods. I have also woken up twice and had what I could best describe as blackened vision right in front of me, which only got better after repeated blinking. During this time I didn't have any other symptoms.
Curently on 25mg Toprol XL 2X daily, 2.5mg Diazapem 2X daily (tapering off) and 10mg Paxil daily.
For the longest time I have had an irrartional fear of sleep and since reading about Brugada syndrome it has gotten worse. I am abel to convice myself I don't have any cardiac condtion but Brugada.
1.Would the typical Brugada EKG be obvious to a doctor or could it be easily overlooked?
2. I have a flat chest and thin chest wall and very little pectoral muscles could this cause a false positive with the IRBBB.
3. No history of any cardiac problems in my family and all relatives are alive or lived passed the age of 80 does this lowed the risk of an EP condition?
4.Are vision disturbances common upon wakening? I also have sleep paralysis could the vision problems be a manifestation of that?
5. So far at least 2 cardiologist and 3 internist have looked at my EKGs should I stop worrying?
I am a 21 year old male 5'6 120lbs and in otherwise good health.
Thank you for your time.
Doctor's Answer
by CCF-M.D.-MJM, Mar 09, 2006 12:00AM
Hi Luke,
Brugada syndrome is much more than a right bundle branch block on EKG, it is actually a different morphology of an right bundle branch block that may even be intermittent. The odds of you having brugada syndrome based solely on an imcomplete right bundle branch block on EKG are very low.
1.Would the typical Brugada EKG be obvious to a doctor or could it be easily overlooked?
The EKG pattern can be intermittent and can be missed on a sigle EKG.
2. I have a flat chest and thin chest wall and very little pectoral muscles could this cause a false positive with the IRBBB.
I would need to see the EKG. I am usually not worried about incomplete right bundle branch blocks unless there is a family history of sudden death or syncope.
3. No history of any cardiac problems in my family and all relatives are alive or lived passed the age of 80 does this lowed the risk of an EP condition?
Your risk of an EP condition is EXTREMELY small. A negative family history makes this case stronger. To be completely honest, if I saw you in clinic I would be more worried about an anxiety disorder than bruguda. The incidence of anxiety problems in your age group is over 100 fold more common.
4.Are vision disturbances common upon wakening? I also have sleep paralysis could the vision problems be a manifestation of that?
I don't know a lot about sleep paralysis and am not sure what are the typical symptoms.
5. So far at least 2 cardiologist and 3 internist have looked at my EKGs should I stop worrying?
It sounds to me like you are very low risk. If I had an incomplete RBBB and no ST elevation on EKG and no family history of sudden death, I would not give it a second thought.
I hope this helps. Good luck.
Brugada syndrome is much more than a right bundle branch block on EKG, it is actually a different morphology of an right bundle branch block that may even be intermittent. The odds of you having brugada syndrome based solely on an imcomplete right bundle branch block on EKG are very low.
1.Would the typical Brugada EKG be obvious to a doctor or could it be easily overlooked?
The EKG pattern can be intermittent and can be missed on a sigle EKG.
2. I have a flat chest and thin chest wall and very little pectoral muscles could this cause a false positive with the IRBBB.
I would need to see the EKG. I am usually not worried about incomplete right bundle branch blocks unless there is a family history of sudden death or syncope.
3. No history of any cardiac problems in my family and all relatives are alive or lived passed the age of 80 does this lowed the risk of an EP condition?
Your risk of an EP condition is EXTREMELY small. A negative family history makes this case stronger. To be completely honest, if I saw you in clinic I would be more worried about an anxiety disorder than bruguda. The incidence of anxiety problems in your age group is over 100 fold more common.
4.Are vision disturbances common upon wakening? I also have sleep paralysis could the vision problems be a manifestation of that?
I don't know a lot about sleep paralysis and am not sure what are the typical symptoms.
5. So far at least 2 cardiologist and 3 internist have looked at my EKGs should I stop worrying?
It sounds to me like you are very low risk. If I had an incomplete RBBB and no ST elevation on EKG and no family history of sudden death, I would not give it a second thought.
I hope this helps. Good luck.
I would be willing to fly out to have tests done as the area I live in leans more towards the anxiety and Gerd syndromes these days,figuratively speaking.
Any input would be helpful.
thanks.
Also instead of flying out I am sure the clinic would be willing to go over your test results. Just get any copies of recent echos, ekg, EP studies, cat scans, MRIs etc. Make sure these are copies of the tests and not the reports or doctors notes as the reports and notes tend to be very subjective.
Any hospital or clinic will provide you with your own copy of any tests you had usually with a small fee if it involves an imaging study, but an EKG just requires a sheet of grid paper.
One more thing if you have had multiple doctors tell you everything is all right try to believe them, especially when you bring up a specific problem or condition. If they just dismiss it, ask them to show you why you can't have the condition by going over your tests in detail. Any good doctor should be willing to do this because it keeps the pateint/doctor relationship open and healthy.
Also If you have a copy of your EKG you can upload it and a doctor here will read it for you.