Coronary angiographic findings in patients with chest pain and rightbundle branch block


Back ground : Coronary artery diseases are not uncommon in the presence of right bundle
branch block .
Aim : The aim of this study is to assess the findings of coronary angiography in patients with
chest pain and right bundle branch block.
Methods : The study involved review of case sheets and coronary angiography of one
hundred patients, who underwent coronary angiography due to chest pain suspected to have
coronary artery diseases (CAD) , fifty patients of them had right bundle branch block (RBBB) ,
the other fifty did not have RBBB , those 100 patients were presented to Ibin Al Bitar hospital
for cardiac surgery from January 2004 to June 2006.
History, clinical examinations, electrocardiogram (ECG) , ECG exercise tests (EET)
echocardiogram (ECHO) and coronary angiography had been performed.
Results : Mean age of patients was 53± 10.6 years, 84% were male , hypertension, diabetes
mellitus, and smoking as risk factors were present as 30%, 32% and 48% respectively. 58% of
patients presented with chronic stable angina (CSA) while 42% with acute coronary syndrome
(ACS), ECHO showed that left ventricular dysfunction (LVD) was present in 34%, EET was
positive in 11 of the 23 patients (47.8%) who were able to perform EET. Normal coronary
angiography found in 20% of patients and there were no significant difference in coronary
angiographic findings between patients with and without RBBB.
Conclusion : RBBB of indeterminate age has no significant impact on clinical and
haemodynamic characteristics of CAD patients and it may be incidental finding.