Left posterior fascicular block: Difference between revisions

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'''For patient information, click [[Heart block (patient information)|here]]'''
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'''Associate Editor-In-Chief:''' {{CZ}}
{{Left posterior fascicular block}}
{{CMG}}; {{AE}} {{CZ}}


{{Editor Join}}
{{SK}} LPFB; left posterior hemiblock; LPH


==Overview==
== [[Left posterior fascicular block overview|Overview]] ==


Left posterior fascicular block (also known as '''LPFB''' or '''Left Posterior Hemiblock''' or '''LPH''') is characterized by a mean frontal plane axis of >90° in the absence of other causes of right axis deviation. Left posterior hemiblock (left posterior fascicular block) is infrequent.<ref>ABC of Clinical Electrocardiography, Morris F, Edhouse J, Brady WJ, Camm J, 2003</ref> Its seen either in the setting of either [[RCA]] or [[LAD]] related pathologies.
== [[Left posterior fascicular block historical perspective|Historical Perspective]] ==


==Anatomical Course of the Left Fascicle==
== [[Left posterior fascicular block pathophysiology|Pathophysiology]] ==


The left posterior fascicle is a [[distal]] extension of the left main bundle and courses posteriorly toward the posterior [[papillary muscle]] which is located in the posterior, medial and inferior aspect of [[left ventricle]] and inferoposteriorly toward the left ventricular free wall. <ref>Pathophysiology of Heart Disease, Lilly LS, 4th edition, 2006</ref>
== [[Left posterior fascicular block causes|Causes]] ==


==Blood Supply of the Left Posterior Fascicle==
== [[Left posterior fascicular block differential diagnosis|Differentiating Left posterior fascicular block from other Diseases]] ==
The proximal part of the left posterior fascicle is supplied by the artery supplying the atrioventricular (AV) node (often the [[right coronary artery]]) and, at times, by septal branches of the [[left anterior descending]] ([[LAD]]) artery.


==Causes==
== [[Left posterior fascicular block epidemiology and demographics|Epidemiology and Demographics]] ==
*[[Congenital aortic stenosis]]
*[[Congenital heart disease]] repair
*[[Endocarditis]]
*[[Myocarditis]] secondary to [[diphtheria]]


==Diagnosis==
== [[Left posterior fascicular block risk factors|Risk Factors]] ==


The diagnosis is often made in the context of previous ECGs. The frontal QRS axis is  rightward and there are no other potential causes of [[right axis deviation]] such as [[right ventricular hypertrophy]] and prior lateral [[myocardial infarction]].
== [[Left posterior fascicular block natural history, complications and prognosis|Natural History, Complications and Prognosis]] ==


*[[QRS]] axis of 100 to 180 degrees
== Diagnosis ==
*[[QRS duration]] 80-100 msec (usually normal or slightly widened qRS complex)
*Deep S in lead I and aVL (rS in I and aVL)
*qR in II, III, and aVF


==Examples==
[[Left posterior fascicular block history and symptoms|History and Symptoms]] | [[Left posterior fascicular block physical examination|Physical Examination]] | [[Left posterior fascicular block laboratory findings|Laboratory Findings]] | [[Left posterior fascicular block chest x ray|Chest X Ray]] | [[Left posterior fascicular block electrocardiogram|Electrocardiogram]] | [[Left posterior fascicular block echocardiography or ultrasound|Echocardiography]] | [[Left posterior fascicular block other  imaging findings|Other Imaging Findings]] | [[Left posterior fascicular block other diagnostic studies|Other Diagnostic Studies]]


==References==
== Treatment ==
{{Reflist|2}}


==See Also==
[[Left posterior fascicular block medical therapy|Medical Therapy]] | [[Left posterior fascicular block surgery|Surgery]] | [[Left posterior fascicular block primary prevention|Primary Prevention]] | [[Left posterior fascicular block secondary prevention|Secondary Prevention]] | [[Left posterior fascicular block cost-effectiveness of therapy|Cost Effectiveness of Therapy]] | [[Left posterior fascicular block future or investigational therapies|Future or Investigational Therapies]]
 
==Case Studies==
 
[[Left posterior fascicular block case study one|Case #1]]


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{{Electrocardiography}}
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[[Category:Electrophysiology]]
[[Category:Electrophysiology]]
[[Category:Cardiology]]
[[Category:Cardiology]]
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Latest revision as of 18:45, 7 February 2013

For patient information, click here

Left posterior fascicular block Microchapters

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Overview

Historical Perspective

Pathophysiology

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Differentiating Left posterior fascicular block from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Chest X Ray

Electrocardiogram

Echocardiography

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

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Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Synonyms and keywords: LPFB; left posterior hemiblock; LPH

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Left posterior fascicular block from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Chest X Ray | Electrocardiogram | Echocardiography | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1


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