Changing axis deviation and intermittent right bundle branch block during acute myocardial infarction

Abstract

Dissimilar electrocardiographic patterns associated with right bundle branch block have been described. The prognosis of right bundle branch block in the absence of underlying cardiac disease is good but it may be poor in other cases, particularly coronary artery disease. Changing bundle branch block, new right bundle branch block, right bundle branch conduction disturbances have been reported in literature. Changing axis deviation has been reported alone or during acute myocardial infarction also associated with atrial fibrillation. Intermittent right axis deviation has been rarely reported in the presence of left bundle branch block also during atrial fibrillation and with acute myocardial infarction too. Isolated left posterior hemiblock is a very rare finding and transient right axis deviation associated with a left posterior hemiblock pattern has been also rarely described associated with acute myocardial infarction. We describe a case of changing axis deviation with intermittent right bundle branch block in a patient admitted with acute myocardial infarction. Also this case focuses attention on changing axis deviation and intermittent right bundle branch block during acute myocardial infarction.