Aims: Left bundle branch block (LBBB) is generally associated with a poorer
prognosis in comparison to normal intraventricular conduction, but also in
comparison to right bundle branch block which is generally considered to be
benign in the absence of an underlying cardiac disorder like congenital heart
disease. In this paper we
evaluate the presence of possible cardiovascular pathology in a group of nurses
with a low level of cardiovascular risk factors and left bundle branch block
(LBBB). Methods: During the period 2009-2013, 356 nurses (mean age: 32.6 ± 11
yr) were admitted to the department of Occupational Medicine of Second University
of Naples. Of these, 13 had LBBB. The evaluation of these patients has included
an electrocardiogram (ECG), echocardiography, 24-h ambulatory Holter monitoring
(ECG Holter), and exercise testing. Subsequently, in patients with LBBB,
multislice computed coronary angiography (MSCT) has been considered. Results
and Conclusion: Only in one patient we found a significant stenosis in the
middle tract of left anterior descending artery. Coronary artery disease
remains difficult to diagnose in some ECG findings such as acquired LBBB. For this reason, a preventive diagnose with newly developed diagnostic
methods such as the multislice computed
coronary angiography (MSCT) must try to account by
the clinician in order to ruling
out coronary artery disease (CAD) in workers with LBBB and low cardiovascular
risk.
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