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ABSTRACT. The left bundle branch block (LBBB) causes an abnormal pattern of cardiac activation and affects regional myocardial function. Although the recognition of LBBB on the surface electrocardiogram is straightforward, dissecting its effect on patient treatment and outcome can be more challenging. In order to assess the current incidence and meaning of the left bundle-branch block associated with atherosclerotic coronary artery disease (CAD) we prospectively studied 402 LBBB patients admitted between January 2011 and June 2013 in Georgescu Institute of Cardiovascular Diseases. Of these, 272 had new or presumably new left bundle branch block and were less likely to have a reserved prognostic induced by an ejection fraction of less than 30% (28.6% vs. 35.3%, p = 0.038). Creatine kinase-MB and troponin T values were more frequently elevated in patients with new or presumably new LBBB (20.2% vs. 5.3%, p = 0.0001 and 17.6% vs. 5.3%, p = 0.0001). Chest pain was the most frequent symptom at presentation (76.86%). Conventional coronary angiography was performed in 226 (92.2%) patients with new or presumably new LBBB and demonstrated that almost 50% (43.81%) of them have CAD, one in five patients being diagnosed with acute coronary syndromes. In a clinical context, the new LBBB suggests high CAD probability and such patients should be evaluated through coronary angiography. pp. 160–166

Keywords: left bundle branch block; coronary artery disease; chest pain; coronary angiography

Larisa Anghel
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Grigore T. Popa University of Medicine, Romania
Catalina Arsenescu Georgescu
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Grigore T. Popa University of Medicine, Romania

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