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What could be the cause of a right bundle branch block?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

I have an abnormal ECG that shows the first-degree atrioventricular block and right bundle branch block. What could be the problem that is causing this?

Please help.

Thank you.

Answered by Dr. Isaac Gana

Hello,

Welcome to icliniq.com.

I understand your concern.

I have seen the report (attachment removed to protect patient identity). Please do not worry, you will be fine. The AV block (atrioventricular) and right bundle branch block are normal changes. We see amongst the healthy population.

Some causes of these changes include medications such as beta-blockers, calcium blockers, cardiac glycosides, myocarditis, myocardial infarction, etc. You can only be worried if you have symptoms. Are you exhibiting any symptoms?

I hope that you get your answer.

Please let me know if you want some help.

Thank you.

Patient's Query

Hi doctor,

Thank you for your reply.

I have not been diagnosed with myocarditis. However, I have been diagnosed with RBBB by the ECG. I did a little research of my own about my condition and apparently, some people with sleep apnea develop pulmonary hypertension. Sleep apnea can lead to increased pulmonary artery pressure and this increase occurs due to the repeating loss of oxygen in the bloodstream due to apneas.

This, in turn, causes the right bundle branch block to occur. So I was wondering if sleep apnea could be the indirect cause of why I have RBBB. I had a sleep study conducted three years ago, and my results showed that I stopped breathing 19 times within the four hours I slept. This is what is leading me to believe the reason I was diagnosed with RBBB is that I had sleep apnea at the time I was tested.

Please guide.

Thank you.

Answered by Dr. Isaac Gana

Hello,

Welcome back to icliniq.com.

Yes, you did good research. Sleep apnea can cause a build-up of pressure in the lungs leading to pulmonary hypertension which in turn causes RBBB (right bundle branch block). However, there are other causes like pulmonary embolism, hypertension, etc.

If your sleep apnea is properly treated, RBBB will be relieved. Are you still experiencing sleep apnea? Do you have other concomitant diseases like diabetes or hypertension? What are you doing in regards to your weight? Because you are obese. Your BMI (body mass index) is 30. Losing weight helps reduce sleep apnea to a great length.

I hope that you get your answer.

Please let me know if you want some help.

Thank you.

Patient's Query

Hi doctor,

Thank you for your reply.

I do not have pulmonary embolism, diabetes, or hypertension. That ECG was conducted while I was serving overseas at the age of 25. I was the same size then as I am now, and I am still having issues with sleep apnea now, just as I did back then, i.e., falling asleep during the day, waking up with headaches, etc. Can you please write a detailed opinion stating the underlying causes of why I have a right bundle branch block condition?

Please guide.

Thank you.

Answered by Dr. Isaac Gana

Hi,

Welcome back to icliniq.com.

Many diseases predispose people to RBBB. A majority, of the time they are benign but in your situation, it is a consequence of your sleep apnea. In sleep apnea, there is an obstruction in the airways.

Due to the obstruction, the amount of oxygen that gets to the body especially the right part of the heart is reduced. This raises the pressure in the right ventricle of the heart, which leads to disruption in the electrical conduction of the right bundle branches of the heart, therefore, reflecting as the right bundle branch block on ECG.

I hope this helps.

Please let me know if you want some help.

Thank you.

Patient's Query

Hi doctor,

Thank you for answering my questions and giving me an explanation about my condition, also the outcome of your opinion is just as I figured it would be. But what I need is a professionally written opinion in letter format signed and dated.

Please help.

Thank you.

Answered by Dr. Isaac Gana

Hi,

Welcome back to icliniq.com.

Sorry for the late reply.

Yes, I can do it after confirmation from the team.

Will get back to you.

Thanks.

Answered byDr. Isaac Gana

Medically reviewed byDr. Vinodhini J.

Published At September 9, 2020
Reviewed AtNovember 22, 2024

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Isaac Gana
Dr. Isaac Gana

Cardiology

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