Q. ECG shows RBBB and marked left ventricular hypertrophy. What does it mean?

Answered by
Dr. Sagar Ramesh Makode
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Mar 27, 2018

Hi doctor,

My son is 12 years old, very active, plays representative basketball and attends a sports high school. Last Sunday, he was knocked over while playing and hurt his arm. After getting up, he fainted. He was fine after that. There were no broken bones, but the medical center did an ECG, and it says on the ECG as non-confirmed diagnosis, incomplete RBBB marked left ventricular hypertrophy.

We took this to a pediatrician and he said his ECG can be normal but said maybe seeing a cardiologist would make us feel better. I have booked in to see one but I would like some reassurance because the appoinment is one month away. The pediatricians report says incidental finding of a partial RBBB and slight tall R waves in V4-V6. I have a copy of the ECG if needed.

#

Hello,

Welcome to icliniq.com.

The ECG (electrocardiogram) is showing incomplete RBBB (right bundle branch block) or early RBBB and features of left ventricular hypertrophy, and also heart rate is on lower side nearing 60 beats per minute. But as you mentioned, he is a basketball player. So, athletic person or one doing exercises get these changes. This is called as athletic heart. So, the first possibility is of athletic heart. Due to chronic exercises, there is thickening of heart wall similar to our biceps on workouts. This is seen as hypertrophy on. ECG and may cause RBBB and minor conduction abnormalities. So overall, it does not look worrisome, but we need to rule out hypertrophic cardiomyopathy as he also has fainting. So he will need echocardiography to confirm the findings. Fainting may otherwise occur due to pain or inadequate food intake as well. I guess there is no family history of sudden unexplained cardiac deaths.

So, get his echocardiography done and try to restrict his sporty activities till echocardiography. Have plenty of water and oral fluids to avoid fainting and syncope.

For more information consult a cardiologist online --> https://www.icliniq.com/ask-a-doctor-online/cardiologist


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