Browsing by Subject "Left bundle branch block"

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    Neonatal lupus with left bundle branch block and cardiomyopathy: a case report
    (BMC, 2020-07-29) Rumancik, Brad; Haggstrom, Anita N.; Ebenroth, Eric S.; Pediatrics, School of Medicine
    Background Cardiac manifestations of neonatal lupus include an array of structural and conduction abnormalities due to placental transference of maternal anti-SSA/Ro and anti-SSB/La autoantibodies. Late-onset neonatal lupus cardiomyopathies, occurring outside the neonatal period, is an infrequently reported manifestation with unknown pathophysiology and poorly defined treatment regimens. Due to the rarity of this condition, additional studies and case reports are required to better understand and manage late-onset neonatal lupus cardiomyopathies. Case presentation A 4-week-old female, born to a mother with known anti-SSA/Ro and anti-SSB/La autoantibodies, presents with classic cutaneous manifestations for neonatal lupus and is found to have left bundle branch block, severely dilated cardiomyopathy with an ejection fraction of 25%, and a thin echogenic dyskinetic ventricular septum. Weekly second trimester and 30-week fetal echocardiograms showed no signs of structural or conduction abnormalities. There were no histologic signs of inflammation on cardiac tissue biopsy. After a complicated hospital course, she was successfully treated with biventricular pacemaker, intravenous immunoglobulin, and plasmapheresis. Conclusions We present a case of late-onset neonatal lupus with severe dilated cardiomyopathy, a dyskinetic ventricular septum, and left bundle branch block. To our knowledge, the dyskinetic ventricular septum has never been reported and left bundle branch block is rarely reported in NL. This case further validates the need for long term cardiac follow up for patients born with NL, even if lacking cardiac manifestations in the peripartum period. We characterize a unique presentation of a rare clinical entity, highlighting the diagnostic challenges, and describe a successful treatment course.
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    Transcatheter Mitral Valve Repair Improves Conduction and Function in a CRT Candidate
    (Elsevier, 2025) Yagasaki, Hiroto; Suzuki, Takeki; Watanabe, Keitaro; Yoshizane, Takashi; Watanabe, Ryota; Warita, Shunichiro; Iwama, Makoto; Noda, Toshiyuki; Medicine, School of Medicine
    Dilated cardiomyopathy (DCM) with severe mitral regurgitation (MR) and left bundle branch block (LBBB) typically indicates cardiac resynchronization therapy (CRT). However, device-related complications can limit CRT's applicability in some patients. A 77-year-old woman with DCM, severe MR, and LBBB underwent mitral valve transcatheter edge-to-edge repair (M-TEER) because of high risk for CRT-related complications. Post-procedure, she showed marked improvement in symptoms, left ventricular function, and QRS duration. This case highlights M-TEER as a potential initial strategy in selected patients with DCM, severe MR, and LBBB when CRT is high risk. The unexpected reduction in QRS duration following M-TEER warrants further investigation. M-TEER may be considered in DCM patients with severe MR and LBBB for whom CRT poses significant challenges. This approach could lead to both mechanical and electrical reverse remodeling in some cases.