RBBB

Hello -

A few years ago while I was lying down on the couch, got up, was going to the bathroom & I got lightheaded and passed out for a second or two and caught myself on the way down.  

Additionally, and I'm not sure if it is related, I have experienced rapid heart rate & palpitations in my chest with some pain.  I went to a cardiologist & my EKG was abnormal with results consistent with a right bundle branch blockage.  My cardiologist seemed to think that it was no big deal but sent me for an ecco anyway, which found nothing abnormal besides a rapid heart rate.  

I have also found that my TSH is high & they found 4 multinodule goiters on my thyroid.  Do you think the thyroid & heart issues are related??  Would the thyroid problems show up as a RBBB?  Finally, how can an EKG say there is a blockage without actually going in and seeing a blockage??

Thanks for any help!!  

[Michael J. McWilliams, M.D.]

Just because you have a right bundle branch block does not mean that I would say that you have heart disease.  It may just be an incidental finding.

Your thyroid hyperactivity and right bundle branch block are probably not related. Hyperthyroidism in your fast heart beat could be related.

The decision about whether to go looking for coronary disease depends on if you have symtoms (symptoms) or many risk factors.  It would also be reasonable to do more tests if the echo was abnormal.  Right bundle branch blocks are common incidental findings.  There are probably no high risk featutres to your history and physical exam -- that is why your doctor didn't do any further testing for coronary disease.  EKGs are not always a great test to look for coronary disease.

I hope this helps.