Fourcade L, Camus O, Roche N, Chenilleau M C, Gil J M, Massoure P L
Hôpital d'instruction des armées Laveran, service de cardiologie, Marseille.
Med Sante Trop. 2014 Jul-Sep;24(3):320-2. doi: 10.1684/mst.2014.0338.
Left bundle branch block (LBBB) during exercise can be associated with chest pain. Though this association is mostly correlated with an underlying coronary artery disease, painful LBBB has been described in patients with normal coronary arteries. We report a case of exercise-induced LBBB with typical angina pectoris related to antimalarial prophylaxis with chloroquine in a 66-year old woman with normal coronary arteries, which was reversed after treatment discontinuation. The effect of chloroquine on the electrophysiological properties of nodal cardiac tissue is responsible for this rate-dependent LBBB. Precautions for future antimalarial prophylaxis are also discussed.
运动期间的左束支传导阻滞（LBBB）可能与胸痛有关。尽管这种关联大多与潜在的冠状动脉疾病相关，但在冠状动脉正常的患者中也有疼痛性LBBB的描述。我们报告一例66岁冠状动脉正常的女性，因使用氯喹进行疟疾预防而出现运动诱发的LBBB并伴有典型心绞痛，停药后LBBB逆转。氯喹对心脏节点组织电生理特性的影响是这种频率依赖性LBBB的原因。本文还讨论了未来疟疾预防的注意事项。
