A 73-year-old man with hypertension presents with two episodes of unexplained syncope over three months. Vital signs: BP 148/92 mmHg, HR 58 bpm, RR 16, temp 37°C, SpO2 98% on room air. ECG demonstrates right bundle branch block with left anterior fascicular block. Troponin is normal. He denies palpitations or chest pain. He takes lisinopril and metoprolol. Which conduction abnormality best explains the clinical significance of these findings?
- A)It is the expected pattern of an athletic heart
- B)It proves the patient has Wolff-Parkinson-White syndrome
- C)It confirms acute pericarditis
- D)It indicates disease in two fascicles of the His-Purkinje system and risk of progression to complete heart blockGABARITO
- E)It reflects isolated AV nodal disease with no prognostic value
Explicação
Bifascicular block means conduction disease in two of the three major ventricular fascicles, usually the right bundle and either the left anterior or left posterior fascicle. In a patient with syncope, this raises concern for intermittent advanced infranodal b... Ver explicação completa e trilha adaptativa →