Certain medical terms can be intimidating when it comes to understanding our children’s health. The "blockade of the right leg of the bundle of His" is one such term that, although it may sound technical, is important to understand, particularly when it comes to our children.
This disorder is caused by an obstruction in a particular area of the heart’s electrical system. The electrical impulses that are transmitted through the bundle of His aid in controlling the heart’s rhythm. It’s critical to treat a blockage in the right leg of this bundle correctly because it may impair the heart’s ability to pump blood efficiently.
It can be concerning if your child is diagnosed with this illness. But there is a big difference in knowing what it is and how to deal with it. This article will explain this blockade, explain how it could impact your child’s health, and suggest steps you can take to protect their wellbeing.
Right bundle branch block (RBBB), also referred to as a blockage of the right leg of the bundle of His, is a condition in which the right side of the heart’s conduction system experiences a delay or blockage in electrical signals. This may impair the heart’s capacity to pump blood effectively and result in irregular cardiac rhythms. RBBB is usually not dangerous and may not even show any symptoms. On the other hand, it may occasionally indicate underlying heart disease. A medical evaluation is necessary to identify the cause and the best course of action, which may involve treating or monitoring any underlying conditions.
About pathology
Before talking about this diagnosis, what it is, one should clearly understand which part of the body is in question. The bundle of His is located in the child"s heart. It is an integral part of the cardiac conduction system and, in fact, externally, it is a bundle consisting of thin fibers of muscle tissue, but not ordinary ones, but somewhat modified. In the interventricular space, in the area of this septum, this bundle branches into two legs – one right and the other left. They branch into a thinner network and connect with the smallest miniature branches, called Purkinje fibers. The smallest fibers pass through the entire muscular wall of the organ – the "motor" and connect with the ventricular myocardium. An electrical impulse passes through these branches from both legs to the small fibers, the heart contracts, beats.
Bundle of the legs of the His bundle is thus called complete or partial (incomplete) pathological change in the ability to conduct an electrical impulse, as a result of which the ventricular myocardium inconsistently and incorrectly enters the excitation phase. Cardiologists do not believe that the blockade of the right or left leg of the bundle of Gis is a separate anomaly, the vast majority of the blocking – just a symptom of some kind of heart disease, vice. The signs of this blockade are noticeable mainly only on the ECG, the decoding of which shows characteristic changes in the schedule of the interventricular septum and ventricular myocardium myocardium. The detection of such a picture is usually random, but requires a more detailed study of the state of the child’s work – there are no diseases and pathologies.
Importantly, experts classify incomplete blockade of the right leg of the bundle of His, which occurs in 5% of pediatric cases, as a variation of normal, albeit strictly individual, cardiac development and not an anomaly.
With the exception of a small (partial) paradoxical anomaly in the interventricular septum’s electrical impulse conduction, these children do not exhibit any symptoms or indicators of heart disease. These issues are typically "outgrown" with age. In the remaining 95% of cases, however, the child is given a comprehensive cardiological examination that will actually indicate what to do next after these symptoms were discovered on the child’s ECG and the parents were notified about the blockage of the right leg of the bundle of His.
Why does this happen?
There are a multitude of reasons why the electrical impulse’s conductivity in this area of the heart may be compromised. Cardiologists report that when there is a significant increase in the size of the right ventricle of the heart, the right leg is most frequently blocked. This can occur in a variety of conditions, such as functional insufficiency of the tricuspid valve, congenital and acquired anomalies of the septum, and mitral stenosis. Acute myocardial infarction, elevated blood pressure, and the so-called pulmonary heart can all be indicated by the blockage of the right leg’s functions.
Medicine does not know the cause of physiological partial blockade, which is not linked to any heart conditions.
What is happening?
The left side of the heart "takes over" the stimulation of the right ventricle’s muscle tissue once the obstruction is fully formed. This is the body’s indirect attempt to make up for the violation. There is a right leg impulse when there is partial blocking, but it is slow and passes later. The distinctive spikes on the graph of an ECG correspond precisely to what a specialist can observe. It should be mentioned that violations of the electric pulse’s conductivity can occur at any age, including infancy, one year, six to eight years old, and adolescence.
How it manifests itself?
- If only one bundle is affected on the right, then there are no symptoms, such a find is a pure accident during a planned ECG.
- If the pathology is accompanied by a certain heart disease, then the signs will be characteristic of a specific disease. Shortness of breath, cyanosis of the nasolabial triangle, pain in the heart, high and rapid fatigue in a child may be associated not with the blockade as such, but directly with an existing cardiac disease.
- If the blockade on the right is complete, then this is usually accompanied by such symptoms as a distinct feeling of one"s own heart rhythm, attacks of dizziness.
What to do?
First and foremost, parents must not give up. A comprehensive cardiac evaluation will be recommended for the child, and it must be completed.
Never undervalue the most widely used form of electrocardiography (ECG). It provides a reasonably accurate indication of the existence of a bundle branch block as well as potential causes of this uncomfortable occurrence.
A child may be prescribed any one of the following types of studies if their physician determines it is necessary:
- a study of the work of the heart through the esophagus is carried out;
- A long-term daily ECG study is carried out (a mini-recorder is attached to the child"s clothes, to the skin, with it he sleeps, eats and tries to lead a normal life for 24 hours).
It is undoubtedly necessary to have a professional consultation with a pediatric cardiologist. This doctor will probably register the child with a dispensary even if the block is physiological following such a "finding" on the ECG. Depending on the specific causes found, parents’ and physicians’ next course of action may vary.
Regardless of which fibers—the front left legs, the back right, a portion of the upper branching, etc.—poorly conduct or do not conduct impulses, the block is not given any particular care. Only after a precise cardiac diagnosis has been made for the child can the question of treatment be addressed.
Medication, such as cardiac glycosides and nitrates, which lower blood pressure, can be prescribed.
Depending on the circumstances, cardiac surgeons may decide to implant an electronic pacemaker in patients with complete blockades, particularly when they are bilateral. Treatment is not necessary for physiological blockade; however, the child will need to undergo dynamic monitoring, or twice a year visits to the cardiologist, and an ECG. Parents can only be informed by a specialist as to what changes in the child’s cardiogram mean and what sinus tachycardia, transient arrhythmia, etc., may follow. d.
Complete right bundle branch block is risky because complications from the underlying heart disease could arise at any time. The prognosis is better when incomplete.
| What is Right Bundle Branch Block (RBBB)? | Right Bundle Branch Block is a condition where the electrical impulses that regulate the heart"s rhythm are delayed or blocked in the right bundle branch of the heart. This can affect the heart"s ability to pump blood efficiently. |
| Symptoms of RBBB | Many people with RBBB have no symptoms. When symptoms do occur, they might include dizziness, palpitations, or shortness of breath. |
| Causes of RBBB | RBBB can be caused by heart disease, high blood pressure, or congenital heart defects. It can also occur in healthy individuals without any underlying heart issues. |
| Diagnosis | RBBB is usually diagnosed through an electrocardiogram (ECG), which records the electrical activity of the heart. |
| Treatment for RBBB | Treatment depends on the underlying cause. If RBBB is due to heart disease, managing the heart condition is key. In some cases, no treatment is needed if RBBB is not causing symptoms. |
| When to See a Doctor | You should see a doctor if you experience symptoms like chest pain, fainting, or persistent dizziness. Regular check-ups are important if you have heart disease or other risk factors. |
It can be unsettling to comprehend a right bundle branch block (RBBB), particularly for parents who are trying to get answers about their child’s health. This disorder interferes with the heart’s electrical conduction, which causes a delay in the signal that passes through the right bundle branch. Even though RBBB can occasionally exist without symptoms, it is crucial to keep an eye on it and treat it as needed.
RBBB is often an incidental finding in children and may not need to be treated right away. Nonetheless, routine medical examinations with a physician are essential to guarantee there are no hidden problems impairing the heart’s operation. In order to track the condition over time, doctors frequently advise a battery of tests, including an electrocardiogram (ECG).
When RBBB is identified, the treatment strategy typically focuses on treating any underlying illnesses or related symptoms rather than the block itself. Depending on the child’s general health and any other relevant factors, this may entail medication or a change in lifestyle. Developing a close partnership with a pediatric cardiologist can assist in customizing the best plan of care for your child.
In conclusion, many kids handle a right bundle branch block well with the right supervision and care, even though it can be concerning. The best outcome for your child’s health and wellbeing can be ensured by keeping informed and collaborating with medical professionals.
