Marino Marco, Massaro Gianluca, Carbone Vincenzo, La Fazia Vincenzo Mirco, Stifano Giuseppe, Gaetano Chiricolo, Natale Andrea
Division of Cardiology, Tor Vergata University of Rome, Rome, Italy.
Outpatient Cardiology, Naples, Italy.
JACC Case Rep. 2025 Jun 18;30(15):103751. doi: 10.1016/j.jaccas.2025.103751.
Painful left bundle branch block (LBBB) syndrome is a rare cause of chest pain associated with intermittent LBBB.
We report the case of a 68-year-old man who experienced chest pain during a treadmill test. The temporal relationship between chest pain and the concealed Wenckebach phenomenon in the left bundle branch, along with the absence of documented myocardial ischemia, strongly suggested a diagnosis of painful LBBB syndrome. The patient underwent up-titration of a β-blocker.
The chest pain in painful LBBB syndrome is thought to be related to dyssynchrony in myocardial contraction caused by intermittent depolarization disturbances. Although rare, the Wenckebach phenomenon can complicate conduction in the bundle branches, leading to intermittent LBBB.
疼痛性左束支传导阻滞（LBBB）综合征是与间歇性LBBB相关的胸痛的罕见原因。
我们报告了一名68岁男性在跑步机测试期间出现胸痛的病例。胸痛与左束支隐匿性文氏现象之间的时间关系，以及无记录的心肌缺血，强烈提示疼痛性LBBB综合征的诊断。患者接受了β受体阻滞剂的滴定上调治疗。
疼痛性LBBB综合征中的胸痛被认为与间歇性去极化干扰引起的心肌收缩不同步有关。虽然罕见，但文氏现象可使束支传导复杂化，导致间歇性LBBB。
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