Acute myocardial infarction associated with right bundle branch block and changeable trifascicular block: a case report

• Main Author: Yasser Mohammed Hassanain Elsayed
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2019-01-01
• Series: Journal of Acute Disease
• Subjects: Acute myocardial infarction; Anteroseptal myocardial infarction; Right bundle branch block; Changeable trifascicular block
• Online Access: http://www.jadweb.org/article.asp?issn=2221-6189;year=2019;volume=8;issue=5;spage=215;epage=220;aulast=Elsayed

Rationale: Acute myocardial infarction in the presence of right bundle branch block. Patient concerns: A 70-year-old, male heavy smoker presented with angina and hypertension. Interventions: Electrocardiography, intravenous nitroglycerin infusion, intravenous streptokinase infusion. Diagnosis: Acute myocardial infarction in the presence of with changeable trifascicular heart block. Outcomes: Dramatic clinical improvement with electrocardiographic ST-segment (whether elevation or reciprocal ST-depression) resolution. Lessons: Acute myocardial infarction may be associated right bundle branch block. Accompanied trifascicular heart block had pre-streptokinase left anterior fascicular block with left axis deviation and post-streptokinase left posterior fascicular block with right axis deviation.