Pathology of the conduction system in acquired heart disease complete right bundle branch block

Abstract

1. 1. The conduction system and the entire heart in 9 cases in which the electrocardiographic pattern was that of complete right bundle branch block were studied histopathologically. Eight of these cases were instances of coronary heart disease, and one of myocarditis. 2. 2. There was positive correlation between the electrocardiographic pattern of complete right bundle branch block and the presence of significant pathologic changes in the right bundle branch. 3. 3. There was no correlation with any other pathologic finding in the heart. 4. 4. Thus, the electrocardiographic pattern of complete right bundle branch block has an anatomic base in significant lesions in the right bundle branch in coronary heart disease. The anatomic base of this complex in congenital or other types of heart disease is not discussed in this work. 5. 5. Right ventricular hypertrophy was correctly diagnosed electrocardiographically in the presence of complete right bundle branch block. In coronary heart disease the combination of complete right bundle branch block and right ventricular hypertrophy may obscure the electrocardiographic manifestations of left ventricular hypertrophy, with or without an incomplete left bundle branch block.