Athar S M, Chin B S P, Flint E J
Medical Assessment Unit, Russells Hall Hospital, Dudley DY1 2HQ, UK.
Postgrad Med J. 2002 Sep;78(923):555-8. doi: 10.1136/pmj.78.923.555.
A 61 year old man developed acute pulmonary embolism while in hospital. His previous and admission electrocardiograms (ECGs) showed a typical left bundle branch block (LBBB) pattern. Immediately after the onset of acute pulmonary embolism, LBBB disappeared from his body surface ECG with sinus bradycardia, normalisation of QRS duration, prolonged QT interval, and marked T abnormalities to the right precordial leads. Recovery from pulmonary embolism resulted in reappearance of his left bundle branch pattern. Delayed conduction of the previously unaffected right bundle branch resulting in roughly equivalent onset of ventricular activation is the most likely reason. Rate dependent LBBB is also discussed.
一名61岁男性在住院期间发生急性肺栓塞。他之前及入院时的心电图（ECG）显示为典型的左束支传导阻滞（LBBB）图形。急性肺栓塞发作后，体表心电图上LBBB消失，出现窦性心动过缓、QRS时限正常化、QT间期延长以及右胸前导联明显的T波异常。肺栓塞恢复后，左束支图形再次出现。最可能的原因是先前未受影响的右束支传导延迟，导致心室激动大致同时开始。文中还讨论了频率依赖性LBBB。
