| Hemiblocks revisited. | |
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MedLine Citation:
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PMID: 17339573 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The trifascicular nature of the intraventricular conduction system and the concept of trifascicular block and hemiblock were described by Rosenbaum and his coworkers in 1968. Since then, anatomic, pathological, electrophysiological, and clinical studies have confirmed the original description and scarce advances have been developed on the subject. In the present study, we attempt to review and redefine reliable criteria for the electrocardiographic and vectorcardiographic diagnosis of left anterior and posterior hemiblock. One of the most important problems related to hemiblocks is that they may simulate or conceal the electrocardiographic signs of myocardial infarction or myocardial ischemia and may mask or simulate ventricular hypertrophy. Illustrative examples of these associations are shown to help the interpretation of electrocardiograms. The incidence and prevalence of the hemiblocks is presented based on studies performed in hospital patients and general populations. One of the most common causes of hemiblocks is coronary artery disease, and there is a particularly frequent association between anteroseptal myocardial infarction and left anterior hemiblock. The second most important cause is arterial hypertension, followed by cardiomyopathies and Lev and Lenègre diseases. The hemiblocks may also occur in aortic heart disease and congenital cardiopathies. Left anterior hemiblock is more common in men and increases in frequency with advancing age. Evidence is presented regarding the relationship of spontaneous closure of ventricular septal defects, which may explain the finding of this and other conduction defects in young populations. Isolated left anterior hemiblock is a relatively frequent finding in subjects devoid of evidence of structural heart disease. Conversely, isolated left posterior hemiblock is a very rare finding; its prognostic significance is unknown and is commonly associated with right bundle-branch block. The most remarkable feature of this association is that the prognosis is much more serious with a great propensity to develop complete atrioventricular block and Adams-Stoke seizures. |
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Authors:
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Marcelo V Elizari; Rafael S Acunzo; Marcela Ferreiro |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
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Title: Circulation Volume: 115 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2007 Mar |
Date Detail:
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Created Date: 2007-03-06 Completed Date: 2007-03-27 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 1154-63 Citation Subset: AIM; IM |
Affiliation:
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Division of Cardiology, Ramos Mejía Hospital, Urquiza 609, Buenos Aires C1221ADC, Argentina. elizarimv@fibertel.com.ar |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adams-Stokes Syndrome
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etiology Adolescent Adult Aged Bundle-Branch Block / complications, diagnosis, physiopathology Diagnostic Errors Electrocardiography* Female Heart Block / classification, complications, diagnosis*, epidemiology, physiopathology Heart Conduction System / anatomy & histology, physiopathology Humans Hypertrophy, Left Ventricular / complications, diagnosis Male Middle Aged Myocardial Infarction / complications, diagnosis Prevalence Prognosis Retrospective Studies Vectorcardiography* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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