Doctors Lounge - Cardiology Answers
provided on www.doctorslounge.com is designed to support, not
replace, the relationship that exists between a patient/site
visitor and his/her physician."
Back to Cardiology Answers List
- Mon Jan 05, 2009 4:17 am
18, Male, good health, no pre-existing conditions to speak of.
I recently was hit in the chest while working in my garage. Without explaining how it happened the impact was similar to a 10 pound weight being dropped onto my chest from 20 feet high. The impact was over the heart but closest to the sternum. It spans about 8 inches vertically but hurts the most over the heart. The pain heightens when I breathe in deep or stretch the area. It has been 10 days and I feel better everyday. I haven't felt any difference in my heart though I haven't been able to exercise yet to fully test it.
At the hospital they found that I have a LEFT bundle branch blockage. My dad has a right bundle branch blockage.
Is my blockage most likely genetic or could it be from the impact? If it isn't genetic is medical care needed? Should I see a cardiologist?
| John Kenyon, CNA
- Mon Jan 05, 2009 9:31 pm
Hi there -
First, it will help with future discussions with other medical people, to straighten out the terminology: what you're talking about is left bundle branch block (LBBB), not blockage. This is an important distinction, as blockages involve arteries feeding parts of the heart, while a "block" is an electrical problem, in this case the left ventricle beating just a hair after the right one instead of both at the exact same time.
Since there's a history of BBB in your family (your dad's RBBB is generally of less concern) this could be some sort of inherited thing, but LBBB is often associated with congenital defects or injuries, so most all patients with LBBB are worked up for structural defects and specific details of their block as well, since it is a more complicated issue than RBBB. It also could be a result of the blow to the chest, since cardiac trauma is often overlooked and not always symptomatic except for the orthopedic pain caused by the blow. You seem to be recovering nicely, so if this bundle branch block disappears, it may have been related to the injury (and that would have been quite a hit! You're very lucky it didn't knock the heart out of rhythm). So what you'll need now, in order to determine why this is showing up, is to have an EKG (you've already had that done), an echocardiogram (an ultrasound look at the inside structures of the heart), and bloodwork to determine if you have some irritation or injury to the heart muscle or the sac around the heart. This could account for the pain you're feeling, although it's just as likely superficial bone and soft tissue trauma. It's important to be certain there's no injury to the heart itself. If there isn't, once the discomfort has resolved you'll need to be followed for this problem, as some people have LBBB for no apparent reason and it can eventually become a problem requiring a pacemaker. While this is far from a sure thing in your case, since it may be due to the thing falling on your chest, it also could be a congenital problem. Again, right bundle branch block, such as your father has, is generally not a problem. LBBB can be moreso in some cases.
It's impossible to say if this was there before the accident, so it's very important to determine whether or not that's what caused it, as it may well go away if that's what caused it. Otherwise you'll need to be followed up by a cardiologist over time to make sure it doesn't progress to a more troublesome sort of block.
I hope this is helpful. Best of luck to you with this and please follow up with us as needed.