RBBB

A right bundle branch block is defined by a wide QRS (> 120 ms), a dominant R wave in V1 and a RSR’ pattern (“M”) in V1 with a wide S wave (“W”) in V6.

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In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Anterior ST depression Inferior ST elevation Wide QRS LPFB RBBB Acute Inferior MI Acute Posterior MI Dr Smith's ECG Blog CC BY-NC
Teach your learners: when the QRS is wide, the J-point will hide, so trace it down and copy it over!

This ECG is from a middle aged man who presented with chest pain and diaphoresis while exercising. He had a VSD repair at age 6.

This ECG shows sinus tachycardia with RBBB + LPFB. ST elevation in III and aVF with reciprocal ST depression in aVL. ST depression in V2-5. The cause was inferoposterior MI, due to severe triple vessel disease and a culprit 100% circumflex occlusion.

In the ECGquest archives, this ECG has been tagged with: - Cardiac arrest Dyspnoea 12-Lead Anterior ST elevation Lateral ST elevation Sinus tachycardia LAFB RBBB Left main occlusion Dr Smith's ECG Blog CC BY-NC
How does acute left main occlusion present on the ECG? Case 2

This ECG is from a young woman who presented with sudden pulmonary oedema. This ECG was recorded just before she arrested.

This ECG shows sinus tachycardia, RBBB, LAFB and ST elevation in V2-6, I and aVL. The cause was a 100% left main occlusion.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Anterior ST elevation Bifascicular block LAFB RBBB Multi-vessel disease Dr Smith's ECG Blog CC BY-NC
What is the Diagnosis in this 70-something with Chest Pain?

This ECG is from a man in his 70s who presented with chest pain.

This ECG shows RBBB, LAFB and ST elevation V2-4. The troponin was very high due to a very large infarct. The cause was 3 vessel disease. The rhythm is also grouped, possibly bigeminy.

In the ECGquest archives, this ECG has been tagged with: - Dyspnoea 12-Lead Lateral ST elevation ST elevation in aVL RBBB Normal ST elevation Dr Smith's ECG Blog CC BY-NC
Two patients with RBBB

This ECG is from a woman in her 60s who presented with dyspnoea, on a background of chronic respiratory disease.

This ECG shows RBBB with ST elevation in I and aVL. All previous ECGs were identical, so this was most likely her baseline ST elevation. Troponins and echo were normal.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Dyspnoea 12-Lead Inferior ST elevation Lateral ST elevation RBBB Acute Lateral MI Dr Smith's ECG Blog CC BY-NC
Two patients with RBBB

This ECG is from a man in his 50s who presented with intermittent chest pain and shortness of breath for the past 3 days with vomiting.

This ECG shows RBBB with inferior and lateral ST elevation due to an acute MI (occluded OM2).

In the ECGquest archives, this ECG has been tagged with: - Dyspnoea Palpitations 12-Lead RSR' Wide QRS RBBB EMergucate CC-BY-NC-SA
ECG of the Week – 8th April 2019 – Interpretation

This ECG is from a woman in her 30s who presented with palpitations and intermittent shortness of breath.

This ECG shows wide QRS with RSR' in V1 and wide S in V6, consistent with RBBB.

In the ECGquest archives, this ECG has been tagged with: - 12-Lead Tachycardia Wide QRS Change in rhythm Wide complex tachycardia Bifascicular block LAFB RBBB Positive Sgarbossa criteria Dr Smith's ECG Blog CC BY-NC
What is this rhythm? And what else does it show?

This ECG is from a man in his 60s who presented with abdominal pain dyspnoea and altered level of consciousness, in shock.

This ECG shows wide complex tachycardia with concordant ST elevation in V4-6, due to LAD occlusion. The rhythm was likely sinus tachycardia with RBBB and then LAFB mid way through the trace.

In the ECGquest archives, this ECG has been tagged with: - Syncope 12-Lead Left Axis Deviation Long PR Normal rate RSR' Wide QRS First degree AV block LAFB RBBB Trifascicular block ECG of the Week CC-BY-NC-SA
ECG of the Week – 26th November 2018 – Interpretation

This ECG is from a man in his 60s who presented after an episode of syncope.

This ECG shows bifascicular block (RBBB + LAFB) with a first degree AV block. He underwent pacemaker insertion.

In the ECGquest archives, this ECG has been tagged with: - 12-Lead Left Axis Deviation Bifascicular block LAFB RBBB ECG Guru CC-BY-NC-SA
Instructors’ Collection ECG: Bifascicular Block

This ECG is from a woman in her 70s who presented with sepsis.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Dyspnoea 12-Lead Electrode misplacement Lateral ST elevation Left Axis Deviation LAFB RBBB Acute Anterior MI Acute Lateral MI Dr Smith's ECG Blog CC BY-NC
A man in his 80s with chest pain

This ECG is from a man in his 80s who presented with chest pain and shortness of breath. This was the repeat ECG just before he arrested.

In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Left Axis Deviation Long PR Pathological Q waves Regular Wide QRS First degree AV block RBBB ECG Guru CC-BY-NC-SA
Instructors’ Collection ECG: Right Bundle Branch Block With Probable Previous M.I.

This ECG is from an 87 year old man who presented with chest discomfort.

In the ECGquest archives, this ECG has been tagged with: - Dizziness Dyspnoea Syncope 12-Lead Right Axis Deviation RSR' Tachycardia Wide QRS Wide complex tachycardia RBBB Pulmonary embolism Dr Smith's ECG Blog CC BY-NC
RBBB. Is there ST Elevation in III and aVR, with reciprocal ST depression in I and aVL?

This ECG is from a man of unknown age who presented with dizziness and dyspnoea on a background of stage 4 lymphoma. He was tachycardic, tachypnoeic (31) and hypoxic (SpO2 79%). The lungs were clear on auscultation.

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