Left posterior fascicular block: Difference between revisions

Left posterior fascicular block
ICD-10	I44-I45
ICD-9	426.9
DiseasesDB	10477
MeSH	D006327


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

Synonyms and keywords: LPFB; Left Posterior Hemiblock; LPH

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v t e Electrocardiography
Overview	History of the EKG • EKG interpretation basics • Normal sinus rhythm
EKG Complexes	P wave • QRS complex • ST Segment • T wave • T wave alternans • Tombstone T wave • U wave Osborn wave • H wave • K wave • Delta wave NSSTW changes
EKG Intervals	PR Interval • QRS Interval • ST Interval • QT Interval
Conduction System & Bradycardia	Cardiac pacemaker • SA node • AV node• Bundle of His • Purkinje fibers • Sinus bradycardia • First Degree AV Block • Second Degree AV Block • Complete or Third-Degree AV Block • Concealed conduction • AV Junctional Rhythms • LBBB • LAHB • LPHB • RBBB • Trifascicular block
Atrial Arrhythmias	Sinus tachycardia • Premature Atrial Contractions (PACs) • Ectopic Atrial Rhythm • Paroxysmal Atrial Tachycardia (PAT) • Paroxysmal Atrial Tachycardia (PAT) with Block • Multifocal Atrial Tachycardia (MAT) • Atrial Flutter • Atrial Fibrillation • Wandering atrial pacemaker
Ventricular Arrhythmias	Differential Diagnosis of Tachycardia with a Wide QRS Complex • Accelerated Idioventricular Rhythm • Ventricular Parasystole • Premature Ventricular Contractions (PVCs) • Ventricular tachycardia • Ventricular Fibrillation • Sudden cardiac death
EKG Abnormalities in Disease States	Hypertrophy & Dilatation • Right atrial enlargement • Left atrial enlargement • Biatrial enlargement • Left Ventricular Hypertrophy • Right Ventricular Hypertrophy • Biventricular Hypertrophy • Acute myocardial infarction • NSTEMI • STEMI • Tombstone ST elevation • Right ventricular myocardial infarction • Atrial infarction Pre-excitation Syndromes • Wolff-Parkinson-White Syndrome • Lown Ganong Levine Syndrome • Mahaim Type Preexcitation Cardiomyopathies • Arrhythmogenic Right Ventricular Dysplasia • Dilated Cardiomyopathy • Hypertrophic Cardiomyopathy Drug Effects on the EKG • Adenosine • β-blockers • Digitalis • Quinidine • Procainamide • Disopyramide • Lidocaine • Tocainide and Mexiletine • Phenytoin • Encainide, Flecainide and Propafenone • Amiodarone • Bretylium • Ca Channel Blockers • Phenothiazines • Tricyclic Antidepressants • Lithium Congenital Heart Disease • Dextrocardia • Atrial Septal Defect • Ventricular Septal Defect • Tetralogy of Fallot • Conjoined Twins or Siamese Twins • Congenital heart block Electrolyte Disturbances • Hyperkalemia • Hypokalemia • Hypercalcemia • Hypocalcemia • Nonspecific Changes Other Heart Diseases • Pericarditis • Myocarditis • Tamponade • Heart Transplantation • Sick Sinus Syndrome • Long QT Syndrome Inherited Disease • Brugada Syndrome Systemic Diseases • CNS Disease • Cardiac Tumors Heart Transplantation • EKG Changes in patient with Heart Transplantation Exogenous Effects • Hypothermia • Chest Trauma • Insect Bites • Electric Injuries
Technical Issues and Potential Errors in Interpretation	Artifacts • Lead Placement Errors • The EKG in a Patient with a Pacemaker • EKG in athletes

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 {{SK}} LPFB; Left Posterior Hemiblock; LPH
-==Overview==
-Left posterior fascicular block 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.
-==Anatomical Course of the Left Fascicle==
-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>
-==Blood Supply of the Left Posterior Fascicle==
-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==
-*[[Congenital aortic stenosis]]
-*[[Congenital heart disease]] repair
-*[[Endocarditis]]
-*[[Myocarditis]] secondary to [[diphtheria]]
-==Diagnosis==
-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]].
-*[[QRS]] axis of 100 to 180 degrees
-*[[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==
 ==References==

Left posterior fascicular block: Difference between revisions

Revision as of 10:49, 24 August 2012

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