Left Bundle Block - referral?

[Marionfromhappydays]

Whilst attending pro op assessment for spinal surgery it was spotted on the ecg i had heart bundle block, totally new to me!I spoke with the anaesthetist who would not continue with the operation until they found out more about the bundle block.

I've had an echo, cardiologist says echo picture quality wasn't great but it's showing i do have Left bundle block and have borderline / mild reduced ejection fraction.

She advised my GP to test my BNP (was normal) and to control hypertension (been put on ramipril, BP was 148/72). I just need to pick my prescription up for this.

I asked my GP if I was being referred to cardiology and she said no as BNP normal.

All I've learnt about Left bundle block of from the Internet, my GP couldn't offer any help, the cardiologist report (report back from ecg) stated it was OK to refer for further tests (I read this on the NHS app).

I am 50 so would like to know why I have LBB and how it might affect me in the future.

Should I go back to my GP and asked to be referred ?

Unsure how serious this is, I don't want to come back in few years time with heart failure

Many thanks for your help

[RufusScamp]

I was diagnosed with LBBB 5 years ago, along with severe heart failure. I am still going, having been discharged by my cardiologist as my EF has improved. Keep taking the tablets, and good luck!

[Marionfromhappydays in reply to RufusScamp]

Thank you so much , so glad to hear you are doing well x

[PinkKizzie in reply to RufusScamp]

Hi RufusScamp, hope you don't mind me asking, do you have a pacemaker? I was diagnosed with LBBB, LV impairment and an EF of 25% 2years ago. Was supposed to get a pacemaker but that didn't go to plan. I've not had an echo again to see if my EF has improved even although I don't have a pacemaker. My question is, can you improve your EF with medication only? Take care.

[Lezzers in reply to PinkKizzie]

In answer to your question ' can you improve your EF with medication only' the answer is absolutely yes you can. My husband's EF went from 30 to 51 with medication only, he did have an ICD but it wasn't programmed to pace him it was there purely to shock his heart if necessary. His heart failure is due to damage caused by a heart attack, if your HF is being caused by an electrical problem that might be a different issue. Could you ask your cardiologist or maybe ask the BHF nurses?

[RufusScamp in reply to PinkKizzie]

Pacemaker and Entresto, and my EF went from 20% to 60% over several months. I don't know if the meds alone would have done as much as I had the device fitted before she moved me onto Entresto.

[PinkKizzie in reply to RufusScamp]

Thank you for your response RufusScamp, I'm really pleased to hear that your EF has increased greatly. I do feel a lot better now compared to the beginning of my heart failure, so I'm guessing my EF has improved. I'm glad I'm on Entresto too. Take care.

[Lezzers]

My husband has recently been diagnosed with LBBB. His nurse said that this wouldn't normally be a problem for most people but because my husbands health is complex, he has severe heart failure amongst other things, he's having a CRT-d fitted on Monday, he currently has an ICD.

His nurse explained that for most people the ventricles beat in sync, however when you have LBBB the heart beat (in my husband's case ) goes through one ventricle & travels to the next ventricle before it beats causing a slow heart beat. This wouldn't be an issue but because he also has bradycardia (slow heart beat) this is causing his ICD to pace him too much which can further damage his heart. The CRT-d should hopefully make his heart beat in sync 🤞

My understanding is LBBB isn't curable but is controllable to the point your heart can start beating normally & it shouldn't really impact on your life or worsen. It's great that your BNP is normal as this is used as an initial tool for HF diagnosis, you would usually only be referred to cardiology if this was elevated.

Hope this helps/makes sense!

[Marionfromhappydays in reply to Lezzers]

Thank you so much for your reply, it's so informative!

Sorry to read about your husband, good that he's receiving good care, I hope the new pace maker does the trick . Sure it helps a lot that you are so supportive and knowledgeable too.

Really appreciate your reply, so easy to let your mind wander about matters

[Lezzers in reply to Marionfromhappydays]

Thank you for your kind words. My husband has cognitive issues due to down time after a cardiac arrest. I deal with all his health issues & I try to learn everything I can about his various health conditions so that I'm able to understand & discuss treatments, fight his corner etc. And yes thankfully he gets very good care from his medical team.

It might be worth your while having a chat with the BHF nurses on this site. They're absolutely brilliant in explaining things & giving advice etc. I'll find their phone number for you

Edit

f you have any questions or concerns, and would like to speak with one of our cardiac nurses, please do contact our Heart Helpline team on 0300 330 3311 Mon-Fri 9-5pm or email

Good luck 🤞

[Marionfromhappydays in reply to Lezzers]

That would be wonderful, thank you so much; I didn't realise I could speak to a nurse, this is great.

With previous experiences I've found it's so vital to have someone in your corner, I'm sure your husband appreciates you so much. Sometimes it can get quite wearying, hope you take some time for yourself too 😉

It will really help speaking to a specialist nurse, thanknyou so much for this suggestion

[Lezzers in reply to Marionfromhappydays]

I've edited my last reply with the phone number for the BHF nurses. Good luck 🤞

[Marionfromhappydays]

I hope your pacemaker (when you receive it) improves your symptoms, must be frustrating having to wait.

So far I've no symptoms, I was very surprised to be told I had an issue. Echo showed no structural issues but I'm guessing it wouldn't show problems with arteries etc.

I would like to know why it's occurred. Guess it's good reason to take better care of myself!

[Scotsman53 in reply to Marionfromhappydays]

Some people have no structural issues, just electrical ones, I believe it's fairly common. Like you I was found to have LBBB during a pre-surgical assessment but told it was nothing to worry about and the surgery went ahead. Around 5-6 years later I began to have occasional faint spells, an echo came back normal but they got more frequent and eventually I was found to have heart block, wound up with a pacemaker, everything seems fine now.

[Marionfromhappydays in reply to Scotsman53]

Glad everything is OK now, pacemakers are amazing!

[Petitlady]

I had a cardiology check up when I was 50. I didn’t have any problems at the time but my mum had recently died from heart issues. I was told I had LBBB but there was no need for any follow up. I had no other heart problems I had normal blood pressure and life continued as normal. last year when I was 66 I developed angina, went to the GP was referred for an echocardiogram and diagnosed with severe aortic valve stenosis. Still had the LBBB but there was no suggestion it had led to the problem with the valve. After surgery life is again back to normal. I think LBBB means something is not quite right in your heart’s electrical system. I don’t think there is a medical solution and I don’t think it causes a problem. I also inherited high cholesterol from mum and I think that is linked to aortic stenosis. You may want to ask for further tests but it may just cause you more anxiety without any answers. With regard to the heart valve my cardiologist was quite clear that it was something that happens to some people and that no lifestyle changes would have prevented it. On balance I’m glad I didn’t know something was going on until it needed treatment.

[Marionfromhappydays in reply to Petitlady]

Thank you for your reply, so glad you are feeling well after your operation.

I think I will ring the cardiology nurses and have a chat and that should be enough to put my mind at rest, as you say I will probably cause myself more anxiety with further rests and won't get any resolution.

Thanks for your reply

[Survivor1952]

I had a heart attack in May 23, I was 70 then, which led to 2xPCI, AVR and CABG in May/Jun 23. My EF before surgery was 30%, post discharge it was up to 63%. When I was seen by my local cardiology team after surgery I was told I‘ve got LBBB. Since surgery I’ve started parkrun (first one 3 months after surgery) and I am at an age grade of 43%. Life is completely normal and there is very little I don’t do now. I’m even back competing in my beloved motorsport.

My understanding is that LBB is an electrical issue in that the nerves don’t react as quickly as they should so the muscle contraction is slightly delayed. It is usually a result of other underlying heart conditions such as aortic valve issues or high blood pressure.

[Silvermedal]

I developed angina a few years ago and my ECG showed a LBBB. I had had an ECG when I had a minor op a few years before that, and it showed the LBBB was there then, so I was told it was of no significance as it was longstanding with no symptoms.

Recently I spoke to the BHF nurse helpline about another issue. She was incredibly helpful and reassuring, so I second the suggestion that you do that.

[Manderson27]

I was diagnosed with LBBB a couple of years ago during a health check where they noticed I had never had EKG. My GP referred me to cardiology and after having a 7 day holter an echo and an MRI it was shown that there was no underlying heart disease my EF was marginally down but of no concern at the moment and as there were no other issues with my heart, BP etc they are happy not to prescribe any meds. In my case it is probable that I have had this "electrical" fault in my heart for years possibly decades as I have often had "palpitations" but I just thought this was normal for me so never got it checked. An LBBB is not in itself and issue, they heart amazingly adapts. However knowing for sure that it is not caused by any underlying heart disease was a great relief to me. Personally I would push for a cardio referral for your peace of mind because knowing your heart isn't working in the usual way is very stressful. LBBB is quite common and for a lot of people makes little or no difference to their lives.

[polenta]

I was diagnosed with severe HF 10 years ago with LBBB, HF specialist said the LBBB was keeping my heart from improving with just meds and advised a CRT-D inplant to get my heart beating in sync. My heart started improving almost immediatly and the LBBB went away! Just had my 1st battery change this year and they tested to see if they could get the LBBB to appear, NOPE! I think my LBBB was caused by the weak heart, not the other way around, because once my heart got stronger it went away.

[Sharpglo]

Just to say if I had been diagnosed earlier as you apparently have been, I would have been doing all I could to gain knowledge and do all I could to improve my heart muscle. No diagnosis for me even with signs and not a great future for me.