title: Exercise-induced left bundle branch block: a case report of false positive MIBI imaging and review of the literature.
abstract: Exercise-induced left bundle branch block is a relatively rare finding during exercise tolerance testing. A 36-year-old female with intermittent exercise-induced left bundle branch block, a MIBI study suggesting anterior ischemia and normal coronary arteries is reported. A review of the English and French language literature published from January 1985 to January 1996 is presented. Exercise-induced left bundle branch block has been reported in association with and without structural heart disease. Pooled mortality in the group with structural heart disease was 2.7% per year, and mortality was 0.17% per year when no structural heart disease was identified. Exercise-induced left bundle branch block has been reported to resolve with therapy. Noninvasive testing appears to have limited ability to detect or exclude coronary artery disease in this group. If a definitive cardiac diagnosis is required, strong consideration should be given to coronary angiography.
authors.affiliation: University of British Columbia, Vancouver Hospital and Health Science Centre, bradmunt@u.washington.edu
authors.forename: B
authors.initials: B
authors.lastname: Munt
authors.forename: V F
authors.initials: VF
authors.lastname: Huckell
authors.forename: J
authors.initials: J
authors.lastname: Boone
mesh_terms: D000328:Adult; D002037:Bundle-Branch Block / Q000209:etiology*; D003287:Contrast Media; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D005082:Physical Exertion; D017256:Technetium Tc 99m Sestamibi
chemical_list: D003287:Contrast Media; D017256:Technetium Tc 99m Sestamibi