ABC | Volume 114, Nº4, Suplement, April 2020

Case Report Alencar Neto et al. A painful left bundle branch block syndrome case Arq Bras Cardiol 2020; 114(4Suppl.1):34-37 References This is an open-access article distributed under the terms of the Creative Commons Attribution License Study Association This study is not associated with any thesis or dissertation work. Ethics approval and consent to participate This article does not contain any studies with human participants or animals performed by any of the authors. 1. Eichert H. Transient bundle branch block associated with tachycardia. Am Heart J. United States; 1946 Apr;31:511–8. 2. ViewegWV, Stanton KC, Alpert JS, Hagan AD. Rate-dependent left bundle branch block with angina pectoris and normal coronary arteriograms. Chest 1976;69(1):123–4. 3. Virtanen KS, Heikkila J, Kala R, Siltanen P. Chest pain and rate-dependent left bundle branch block in patients with normal coronary arteriograms. Chest. United States; 1982;81(3):326–31. 4. Riera JC, Martínez GO, Vega J, Gordillo E, Ferreira I, Peña C, et al. El bloqueo de rama izquierda inducido por el ejercicio en pacientes con y sin enfermedad coronaria. Rev Española Cardiol [Internet]. 2002;55(5):474–80. 5. Kafka H, Burggraf GW. Exercise-induced left bundle branch block and chest discomfort without myocardial ischemia. Am J Cardiol. 1984;54(6):676–7. 6. Heinsimer JA, Skelton TN, Califf RM. Case Report: Rate-Related Left Bundle Branch Block with Chest Pain and Normal Coronary Arteriograms Treated by Exercise Training. Am J Med Sci. 1986;292(5):317–9. 7. Shvilkin A, Ellis ER, Gervino E V, Litvak AD, Buxton AE, JosephsonME. Painful left bundle branch block syndrome: Clinical and electrocardiographic features and further directions for evaluation and treatment. Heart Rhythm .2016;13(1):226-32. 8. Shvilkin A, Bojovic B, Vajdic B, Gussak I, Ho KK, Zimetbaum P, et al. Vectorcardiographic and electrocardiographic criteria to distinguish new and old left bundle branch block. Hear Rhythm. 2010;7(8):1085–92. 9. Prakash G, Suryanarayana PG, Frankel DS, Marchlinski FE, Schaller RD. Painful Left Bundle Branch Syndrome Treated Successfully with Permanent His-Bundle Pacing. Heart Case Reports.2018;4(10):439-43. 10. Puerta González-Miró I de la, Piñol-Ripoll G, Río Ligorit A del. Dolor torácico y bloqueo de rama izquierda sin isquemia miocárdica . Na Med Interna.2008;25(5):244-5. Table 1 – Painful LBBB syndrome criteria Abrupt onset of chest pain with development of LBBB Simultaneous resolution of symptoms with resolution of LBBB (occasionally absent) Normal 12-lead ECG before and after LBBB Absence of myocardial ischemia during functional stress test Normal left ventricular function and absence of other conditions that may explain the symptoms Low precordial S/T wave ratio (< 1.8) and inferior axis Criteria proposed for the diagnosis of the painful LBBB syndrome. Adapted from Shvilkin. 7 37