Bundle branch block (BBB) can be induced by exercise. Its significance is affected by a number of factors.

The bundle branch block appears during exercise and may persist for a few hours after.


Left bundle branch block is more common.


Pearls about exercise-induced bundle branch block:

(1) The patient may or may not have coronary artery disease. In patients with coronary artery disease there is often atherosclerosis of the proximal left anterior left coronary artery.

(2) The bundle branch block can become permanent.

(3) It occasionally may be associated with atrioventricular block with need for pacemaker insertion.

(4) A patient with abnormal coronary arteries and BBB is at increased risk for acute myocardial infarction or other major cardiac events.

(5) Chest pain can occur with the LBBB in patients with normal coronary arteries.

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