His bundle blockade - what you need to know about the pathology
Blockage of the legs of the bundle of His is a violation of conduction by a group of cells of the conducting system of the heart in the area of the interventricular septum. Pathology is manifested by dizziness, short-term loss of consciousness, heart rhythm disturbances, or it is detected with the help of an electrocardiogram. Complete blockade of the legs of the bundle of His in a child can develop during intrauterine development or be the result of previously suffered heart diseases.
Varieties of such a blockade are as follows:
- right leg;
- left leg;
- front branch of the left leg;
- of the back branch of the left leg;
- combined.
By the degree of conduction disturbance, the blockade can be complete and incomplete, as well as temporary and permanent. The children's cardiologist will tell you about the danger of incomplete blockade of the leg of the bundle of His in children during the appointment.
Causes of the disease and factors that provoke it
The causes of intracardiac conduction disorders can be various diseases. Thus, in teenagers and children of primary school age, partial blockade of the right leg of the bundle of His can indicate small anomalies of heart development. Blockage of one or both branches of the left leg is the result of acquired heart diseases.
Causes of the disease:
- acquired and congenital heart defects;
- myocardiodystrophy and cardiomyopathies of various origin (metabolic, autoimmune, nutritional);
- cardiosclerosis;
- CHD;
- rheumatism;
- viral or bacterial myocarditis;
- chronic lung diseases;
- myocardial infarction;
- prolonged hypertension;
- thromboembolism of the pulmonary artery.
On our site Dobrobut.com, you can make an appointment with a cardiologist and get answers to the questions that concern you about this pathology. The doctor will prescribe the necessary examination and tell about the treatment of sinus blockade of the right leg of the bundle of His.
Clinical manifestations of the disease
Blockade of the right leg is asymptomatic, and it is often diagnosed accidentally during an electrocardiogram. The absence of symptoms is also characteristic of the blockade of the branches of the left leg of the bundle of His. Clinical manifestations here are caused by the underlying disease.
Blockage of both branches of the left leg is manifested by pain of varying intensity in the heart, dizziness and rapid heartbeat. Myocardial infarction can be one of the causes of pathology.
Symptoms of blockade of both legs of the bundle of His (complete and incomplete) will be frequent dizziness, a tendency to lose consciousness, interruptions in the work of the heart. Such a blockade of His legs is one of the causes of sudden cardiac arrest.
Diagnosis of pathology, signs of blockade of the legs of the bundle of His on the ECG
The main diagnostic methods include: electrocardiography (ECG), rhythmocardiography, daily ECG monitoring and esophageal electrocardiography. MRI, multispiral computed tomography (MSCT) and echocardiography (EchoCG) will help detect organic heart lesions. Additionally, consultations with a cardiologist and cardiac surgeon are recommended.
Signs of bundle branch block on the ECG:
- when blocking the right leg, M-shaped complexes of the Rsr type are detected in leads V1, V2
- with blockade of the left leg in leads V5, V6, I, deformed ventricular complexes without a Q wave with a split apex of the R wave are registered;
- with blockade of both legs, there are signs of blockade of the left and right legs.
Treatment of His bundle blockade
Treatment of pathology can be conservative (therapy of the main disease) and surgical. The operative method of treatment of the blockade is to install a pacemaker to the patient.
Conservative therapy for blockage of one or both legs consists in treating the main cause that caused the pathology.
Drugs recommended for blockade of the His bundle:
- antioxidants (carnitine, Mexidol);
- sedatives (valerian, motherwort);
- hypotensive (to reduce elevated blood pressure);
- antianginal (for the treatment of coronary artery disease);
- preparations for the prevention of thrombosis in blood vessels;
- cardiac glycosides;
- diuretics;
- vitamins of group B;
- preparations for the treatment of bronchopulmonary diseases;
- nonsteroidal anti-inflammatory drugs.
If the cause of the blockade of the right leg of the bundle of His is unknown (if the disease that caused it is not diagnosed), treatment is not prescribed. The cardiologist will tell you about the nuances of therapy for blockade of the left leg of the bundle of His at the appointment.
Complications, prognosis
Complications of His bundle blockade include: ventricular fibrillation, paroxysmal tachycardia, thromboembolism, heart failure (acute, chronic) and asystole.The prognosis in this case depends on the underlying disease, since the blockade of the His bundle is only its symptom. The most favorable prognosis is when the right leg is blocked.
If you still have questions, in particular, whether the legs of the bundle of His are blocked in the army, make an appointment and consult a doctor. The appointment is made on the website and at the specified telephone numbers.
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