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What is your approach to a newly diagnosed LBBB in individuals >70 years old who are free of any signs or symptoms of heart disease and without other significant ASCVD risk factors besides age?

If the ECG was obtained prior to major orthopedic surgery (such as hip replacement) would that change your approach?
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What is your approach to a referral for new LBBB in individuals who are more than 70 years old with no signs or symptoms of heart disease and no ASCVD risk factors beyond age?

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3 Answers
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Cardiology · Interventional cardiologist
Answered on

The presence of BBB; whether IVCD or RBBB or LBBB, signifies infranodal conduction delay from a myopathy. That myopathy may be hypertensive (LVH) or ischemic (LAD disease) or something less common (inflammatory etc).

The ideal test would evaluate anterior septal LV thickness and vascular flow; it’s ...

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Cardiology · Ohio State University Cardiovascular Medicine
Answered on

Personally, I look for any cause other than age - especially long-standing hypertension. If there is none found, I'll check an echo to make sure there isn't an asymptomatic cardiomyopathy everyone would like to know about before surgery. If the EF is normal (or near normal given the LBBB), denies sy...

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Cardiology · UC-Irvine
Answered on

First, I would do my due diligence in reviewing the medical records that the LBBB is truly new onset as opposed newly noticed by healthcare providers. Keep in mind that many have subclinical ASCVD and CAD which may become clinical overtly with physiological stress such as surgery. LBBB by itself is ...

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