Exercise-induced left bundle branch block and its relation to coronary artery disease

Charles Vasey, Jacqueline O'Donnell, Stephen Morris, Paul McHenry

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

The records of 2,584 consecutive patients who underwent both treadmill exercise testing and coronary cineangiography were reviewed to determine the relation between exercise-induced, acceleration-dependent left bundle branch block (LBBB) and the presence of coronary artery disease (CAD). Rate-dependent LBBB during exercise was identified in 28 patients (1.1%), who were categorized according to their presenting symptoms: classic angina pectoris, atypical chest pain, symptomatic cardiac arrhythmia and asymptomatic. Asymptomatic patients underwent a screening exercise test. CAD was present in 7 of 10 patients who presented with classic angina pectoris, but 12 of 13 patients presenting with atypical chest pain had normal coronary arteries. All 10 patients in whom LBBB developed at a heart rate of 125 beats/min or higher were free of CAD, whereas 9 of 18 patients in whom LBBB developed at a heart rate of less than 125 beats/min had CAD. Normal coronary arteries were present in 3 patients who presented with angina and in whom both chest pain and LBBB developed during exercise. It is concluded that (1) patients who present with atypical chest pain in whom rate-dependent LBBB develops on the treadmill are significantly less likely to have CAD than patients who present with classic angina; (2) the onset of LBBB at a heart rate of 125 beats/min or higher is highly correlated with the presence of normal coronary arteries, regardless of patient presentation; and (3) patients with angina in whom both chest pain and LBBB develop during exercise may have normal coronary arteries.

Original languageEnglish
Pages (from-to)892-895
Number of pages4
JournalThe American Journal of Cardiology
Volume56
Issue number13
DOIs
StatePublished - Nov 15 1985

Fingerprint

Bundle-Branch Block
Coronary Artery Disease
Exercise
Chest Pain
Coronary Vessels
Heart Rate
Angina Pectoris
Cineangiography
Exercise Test
Cardiac Arrhythmias

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Exercise-induced left bundle branch block and its relation to coronary artery disease. / Vasey, Charles; O'Donnell, Jacqueline; Morris, Stephen; McHenry, Paul.

In: The American Journal of Cardiology, Vol. 56, No. 13, 15.11.1985, p. 892-895.

Research output: Contribution to journalArticle

Vasey, Charles ; O'Donnell, Jacqueline ; Morris, Stephen ; McHenry, Paul. / Exercise-induced left bundle branch block and its relation to coronary artery disease. In: The American Journal of Cardiology. 1985 ; Vol. 56, No. 13. pp. 892-895.
@article{78e07b94f87a4c048c33fd45d4ab169d,
title = "Exercise-induced left bundle branch block and its relation to coronary artery disease",
abstract = "The records of 2,584 consecutive patients who underwent both treadmill exercise testing and coronary cineangiography were reviewed to determine the relation between exercise-induced, acceleration-dependent left bundle branch block (LBBB) and the presence of coronary artery disease (CAD). Rate-dependent LBBB during exercise was identified in 28 patients (1.1{\%}), who were categorized according to their presenting symptoms: classic angina pectoris, atypical chest pain, symptomatic cardiac arrhythmia and asymptomatic. Asymptomatic patients underwent a screening exercise test. CAD was present in 7 of 10 patients who presented with classic angina pectoris, but 12 of 13 patients presenting with atypical chest pain had normal coronary arteries. All 10 patients in whom LBBB developed at a heart rate of 125 beats/min or higher were free of CAD, whereas 9 of 18 patients in whom LBBB developed at a heart rate of less than 125 beats/min had CAD. Normal coronary arteries were present in 3 patients who presented with angina and in whom both chest pain and LBBB developed during exercise. It is concluded that (1) patients who present with atypical chest pain in whom rate-dependent LBBB develops on the treadmill are significantly less likely to have CAD than patients who present with classic angina; (2) the onset of LBBB at a heart rate of 125 beats/min or higher is highly correlated with the presence of normal coronary arteries, regardless of patient presentation; and (3) patients with angina in whom both chest pain and LBBB develop during exercise may have normal coronary arteries.",
author = "Charles Vasey and Jacqueline O'Donnell and Stephen Morris and Paul McHenry",
year = "1985",
month = "11",
day = "15",
doi = "10.1016/0002-9149(85)90777-5",
language = "English",
volume = "56",
pages = "892--895",
journal = "American Journal of Cardiology",
issn = "0002-9149",
publisher = "Elsevier Inc.",
number = "13",

}

TY - JOUR

T1 - Exercise-induced left bundle branch block and its relation to coronary artery disease

AU - Vasey, Charles

AU - O'Donnell, Jacqueline

AU - Morris, Stephen

AU - McHenry, Paul

PY - 1985/11/15

Y1 - 1985/11/15

N2 - The records of 2,584 consecutive patients who underwent both treadmill exercise testing and coronary cineangiography were reviewed to determine the relation between exercise-induced, acceleration-dependent left bundle branch block (LBBB) and the presence of coronary artery disease (CAD). Rate-dependent LBBB during exercise was identified in 28 patients (1.1%), who were categorized according to their presenting symptoms: classic angina pectoris, atypical chest pain, symptomatic cardiac arrhythmia and asymptomatic. Asymptomatic patients underwent a screening exercise test. CAD was present in 7 of 10 patients who presented with classic angina pectoris, but 12 of 13 patients presenting with atypical chest pain had normal coronary arteries. All 10 patients in whom LBBB developed at a heart rate of 125 beats/min or higher were free of CAD, whereas 9 of 18 patients in whom LBBB developed at a heart rate of less than 125 beats/min had CAD. Normal coronary arteries were present in 3 patients who presented with angina and in whom both chest pain and LBBB developed during exercise. It is concluded that (1) patients who present with atypical chest pain in whom rate-dependent LBBB develops on the treadmill are significantly less likely to have CAD than patients who present with classic angina; (2) the onset of LBBB at a heart rate of 125 beats/min or higher is highly correlated with the presence of normal coronary arteries, regardless of patient presentation; and (3) patients with angina in whom both chest pain and LBBB develop during exercise may have normal coronary arteries.

AB - The records of 2,584 consecutive patients who underwent both treadmill exercise testing and coronary cineangiography were reviewed to determine the relation between exercise-induced, acceleration-dependent left bundle branch block (LBBB) and the presence of coronary artery disease (CAD). Rate-dependent LBBB during exercise was identified in 28 patients (1.1%), who were categorized according to their presenting symptoms: classic angina pectoris, atypical chest pain, symptomatic cardiac arrhythmia and asymptomatic. Asymptomatic patients underwent a screening exercise test. CAD was present in 7 of 10 patients who presented with classic angina pectoris, but 12 of 13 patients presenting with atypical chest pain had normal coronary arteries. All 10 patients in whom LBBB developed at a heart rate of 125 beats/min or higher were free of CAD, whereas 9 of 18 patients in whom LBBB developed at a heart rate of less than 125 beats/min had CAD. Normal coronary arteries were present in 3 patients who presented with angina and in whom both chest pain and LBBB developed during exercise. It is concluded that (1) patients who present with atypical chest pain in whom rate-dependent LBBB develops on the treadmill are significantly less likely to have CAD than patients who present with classic angina; (2) the onset of LBBB at a heart rate of 125 beats/min or higher is highly correlated with the presence of normal coronary arteries, regardless of patient presentation; and (3) patients with angina in whom both chest pain and LBBB develop during exercise may have normal coronary arteries.

UR - http://www.scopus.com/inward/record.url?scp=0022389372&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0022389372&partnerID=8YFLogxK

U2 - 10.1016/0002-9149(85)90777-5

DO - 10.1016/0002-9149(85)90777-5

M3 - Article

C2 - 4061330

AN - SCOPUS:0022389372

VL - 56

SP - 892

EP - 895

JO - American Journal of Cardiology

JF - American Journal of Cardiology

SN - 0002-9149

IS - 13

ER -