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Old 10-29-2011
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EKG What is Right Bundle Branch Block (RBBB)

Hey anyone of you can exactly define the Right bundle branch Block???
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Old 10-29-2011
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Default i love this!!

Right Bundle Branch Block

  • wide QRS, more than 120 ms (3 small squares)
  • secondary R wave in lead V1
  • other features include slurred S wave in lateral leads and T wave changes in the septal leads
  • also remember WiLLiaM MoRRoW (MoRRoW being for RBBB)
  • MoRRoW = M like wave in lead III (can be leads I - III), and W like wave in aVL. the opposite applies for LBBB (WiLLiaM).
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Default for LBBB consider these:

  • left anterior hemiblock
    • QRS axis more left than -30 degrees
    • initial R wave in the inferior leads (II, III and aVF)
    • absence of any other cause of left axis deviation
  • left ventricular hypertrophy
    • In the presence of left anterior hemiblock the diagnostic criteria of LVH are changed. Rosenbaum suggested that an S wave in lead III deeper than 15 mm as predictive of LVH.
  • long PR interval (also called first degree heart block)
    • PR interval longer than 0.2 seconds
  • left atrial hypertrophy
    • M shaped P wave in lead II
    • P wave duration > 0.11 seconds
    • terminal negative component to the P wave in lead V1
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Old 10-29-2011
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Thanx alot seetal it seems you are really working hard n seems i have to cram all this and thanks again for your support....
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Quote:
Originally Posted by rickybhimani31 View Post
Thanx alot seetal it seems you are really working hard n seems i have to cram all this and thanks again for your support....
actually im just doing questions now. not really working so hard. i kinda took my time with step 2 ck KLN and MTB3 reading (like 10 months!!!!) due to internship (still going on). but in our hospital here they ask very detailed questions for our exams like RBBB and LBBB and when we don't know the answer its like we're dumb. here they dont study diseases that are rare like legionaires or RMSF or T.cruzi or acetaminophen poisoning (coz there's no testing for it) but then what they find daily they really go deep. its annoying really but kinda helps me.

things they go deep into are ESRD, SLE, HF, ACS (reading and ECG is a must here) DM (I n II), TB (my God TB is scary here) and ofcourse HIV-AIDS!!!!! but when we had a case of dumping syndrome, guess who was more excited with residents drawing a blank face? so dont worry about RBBB or LBBB. the KLN directs us to what we should know. in america they would rather have us have more knowledge in general rather than these one or two things in great details (or so i think) while the rest is a blur......

try this book for ECG (ECG made ridiculously simple)
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wow seetal thanks for those mnemonics
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Quote:
Originally Posted by sonu.agarwall View Post
wow seetal thanks for those mnemonics
there are not mine. i got it from oxford clinical medicine handbook 8th edition. it explain RBBB and has excellent pictures. please have a look.
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