What are the implications of Right Bundle Branch Block (RBBB) with left axis deviation?

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Last updated: April 11, 2025View editorial policy

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Differential Diagnosis for RBBB with Left Axis Deviation

  • Single most likely diagnosis
    • Left ventricular hypertrophy (LVH): This is the most common cause of left axis deviation in the presence of RBBB, as the increased muscle mass in the left ventricle can lead to a shift in the electrical axis of the heart.
  • Other Likely diagnoses
    • Inferior wall myocardial infarction (MI): An inferior wall MI can cause left axis deviation due to the involvement of the inferior wall, which can affect the electrical conduction pathways of the heart.
    • Cardiomyopathy: Certain types of cardiomyopathy, such as dilated cardiomyopathy, can cause left axis deviation and RBBB due to the enlargement and dysfunction of the left ventricle.
    • Hypertension: Uncontrolled hypertension can lead to LVH, which can cause left axis deviation and RBBB.
  • Do Not Miss diagnoses
    • Tricuspid atresia: This congenital heart defect can cause left axis deviation and RBBB, and is a life-threatening condition if not diagnosed and treated promptly.
    • Cardiac sarcoidosis: This condition can cause left axis deviation and RBBB due to the infiltration of sarcoid granulomas into the heart tissue, and can be life-threatening if not diagnosed and treated.
    • Lyme carditis: This condition can cause left axis deviation and RBBB due to the inflammation of the heart tissue caused by the Lyme disease bacteria.
  • Rare diagnoses
    • Lenegre's disease: This is a rare condition that affects the conduction system of the heart, causing left axis deviation and RBBB.
    • Lev's disease: This is a rare condition that affects the conduction system of the heart, causing left axis deviation and RBBB.
    • Cardiac amyloidosis: This condition can cause left axis deviation and RBBB due to the deposition of amyloid proteins into the heart tissue, and is a rare but serious condition.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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