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TO YOUR GOOD HEALTH #12345_20220902
FOR RELEASE WEEK OF AUGUST. February 29, 2022 (COL. 5)
BY LINE: By Keith Roach, MD
TITLE: The diagnosis of left anterior fascicular block sets off the alarm
DEAR DR. ROACH: I am a 66 year old female who recently had an ECG before my knee surgery. The interpretation I received indicated that I had an abnormal ECG with “left anterior fascicular block”. Needless to say, this alarmed me. I saw a nurse practitioner who said, “Don’t worry about the tongue, your doctor saw the EKG and said everything was fine. Your thoughts, please? –MM
ANSWER: Anytime a person hears that there is a problem with their heart, it raises concerns, so I understand why you weren’t happy with an answer that doesn’t explain what your heart really is. state.
The heart is a wonderful pump, but when the pump works badly, it is called heart failure. The heart has arteries that supply it with blood, containing the oxygen and fuel the heart needs, and when the arteries are blocked, it is called coronary artery disease, which can lead to a heart attack. But the heart also has an electrical supply, with a natural pacemaker and specialized cells that act like wires, called the bundle branches (two of them, right and left), which in turn give rise to smaller divisions called fascicles (the left branch of the fascicle has two fascicles; left anterior and left posterior fascicles).
Just as in a wire harness, electrical transmission through the harnesses and branches of the harness can be blocked. It’s quite common as people get older. The blockage causes delays in conduction through the heart, which can be seen on the electrocardiogram. But, it rarely causes symptoms. In people who otherwise have no heart disease, the presence of left anterior fascicular block (also called left anterior hemiblock) does not increase the risk of heart attack or the need for a pacemaker (although there is a slight increased risk of developing fibrillation, a common abnormal heart rhythm).
People like you with only left anterior fascicular block are also not likely to develop additional blocks, but if multiple conductive pathways are blocked, a pacemaker is often placed. Without any conductive system, the heart will beat at a dangerously slow rate. .
You should tell your doctor if you notice fast or irregular heartbeats or any new symptoms such as shortness of breath.
DEAR DR. ROACH: What makes breasts act like they have a heartbeat? It happens to me anytime, anywhere. Is there a problem? –KG
ANSWER: The breasts are, of course, directly above the heart, and when a person is lying down, both men and women can see the chest move with the pulse. This is especially true in people with strong heartbeats, such as those after exercise. It is very likely that you will see your normal heartbeat transmitted through your breast tissue.
There are some unusual and rare heart conditions that can cause the heart to beat harder, such as a leaky valve that lets blood back into the heart after the heart has pumped blood through the aorta. It makes the heart work very hard.
A careful physical examination by your doctor would be enough to make sure you don’t have any of these worrisome conditions.
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Dr Roach regrets that he cannot respond to individual letters, but will incorporate them into the column whenever possible. Readers can email questions to [email protected] or send mail to 628 Virginia Dr., Orlando, FL 32803.
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