Right bundle-branch block. Occurrence following nonpenetrating chest trauma without evidence of cardiac contusion

Trauma Associated with Cardiac Conduction Abnormalities: Population-Based Perspective, Mechanism and Review of Literature

“…The important factor which needs to be considered is the anteroposterior diameter of the thorax; the narrower the diameter, the greater the impact of deceleration or compression [43]. On the other hand, the possibility of the influence of parasympathetic activity triggered by trauma, which could result in certain potentially reversible cardiac abnormalities, should be considered as well [10].…”

“…Several case reports on traumatic conduction abnormalities have focused on RBBB [10][11][12][13]. Even if an external traumatic impact has a very short duration, the anterior surface of the right ventricle is distorted, producing a direct injury to the right ventricle [43].…”

“…Several case reports have described various cardiac conduction abnormalities such as complete atrioventricular block and left bundle branch block that occurred after the episode of trauma [4][5][6][7][8][9]. Other conduction abnormalities such as right bundle branch or bifascicular blocks have been also reported in the literature [10][11][12][13][14]. The interpretation of these studies, because of their design, could be limited due to confounding and bias.…”

Slow progressing cardiac complications—a case report

“…In some cases, the trauma led to core pulmonal, right-side heart failure; but in other cases, the trauma led to various arrhythmias and AV blocks. 19,[23][24][25] When dealing with electrical disturbances of the heart, there have been numerous cases where there have been transient alterations of rhythm and conduction, 14,26 including right bundlebranch block, 27 complete heart block, 28,29 ST abnormalities, and ventricular fibrillation. These cases had been transient and over a period of days to a week regressed back to normal; however, in one case, a continual complete left-bundle branch block remained.…”

“…However, the normal rhythm had been restored; and a pacemaker was not inserted at the emergency department. 12,14,21,25 There are a number of cases revealing long-term sequelae of blunt trauma to the chest and heart with delayed complications. Some of the long-term problems are chest wall deformity, dysemia, chronic neck pain, depression, fibril thorax headache, idiopathic chronic pain, impaired exercise intolerance, impaired pulmonary function, neuralgias, occupational disability, paresthesia, persistent chest wall pain, restrictive ventilatory defects, sternal pain, and temporal mandibular disorders.…”