Painful left bundle branch block: A syndrome with a particular clinical significance

Christos S Konstantinou; Kallirroi Kalantzi; Konstantinos Tsimos; Eugenia Pappa; Panagiotis Korantzopoulos

doi:10.1016/j.jccase.2020.07.003

Painful left bundle branch block: A syndrome with a particular clinical significance

J Cardiol Cases. 2020 Jul 29;22(6):273-275. doi: 10.1016/j.jccase.2020.07.003. eCollection 2020 Dec.

Authors

Christos S Konstantinou¹, Kallirroi Kalantzi¹, Konstantinos Tsimos¹, Eugenia Pappa², Panagiotis Korantzopoulos¹

Affiliations

¹ First Department of Cardiology, University of Ioannina Medical School, Ioannina, Greece.
² Department of Cardiology, 'G.Hatzikosta' General Hospital of Ioannina, Ioannina, Greece.

Abstract

The development of angina in the setting of new-onset left bundle branch block (LBBB) that resolves at the same time with the disappearance of LBBB, without coexistent myocardial ischemia, denotes the painful LBBB syndrome. In this illustrative case report we describe a young male patient with painful LBBB syndrome. The LBBB was rate-dependent occurring during exercise and the patient was successfully treated with bisoprolol. We also provide a concise review of the literature and we briefly discuss the diagnosis and management of this clinical entity. <Learning objective: Painful left bundle branch block syndrome is a rare clinical entity, that is possibly underdiagnosed. The exclusion of coronary artery disease in a patient with angina pectoris occurring simultaneously with the development of left bundle branch block should raise the suspicion of this syndrome.>.

Keywords: Angina; Left bundle branch block; Normal coronary arteries; Rate-dependent.