Diferencias entre pacientes con bloqueo de rama derecha y hemibloqueo anterior izquierdo en la miocardiopatía chagásica. / [Differences between patients with right bundle branch block and left anterior hemiblock in Chagas myocardiopathy]

ABSTRACT

In order to establish whether different kinds of conduction disturbances like complete right branch block (CRBB) and left anterior hemiblock (LAH) are associated with different degrees of myocardial damage in Chagas disease (Chd), we studied 25 patients (p), 15 males and 10 women (41 +/- 5 years old) who were divided into five groups normal EKG 5 p, incomplete right branch block 5 p, CRBB-LAH 5 p. We performed EKG, phonocardiogram, echo-M, 2-D and Doppler. The systolic function was evaluated with velocity of circumferential shortening and Weissler index; parietal motility with score of motility; dilatation with diastolic diameter of left ventricle and diastolic function with isovolumetric relaxation time and E/A ratio mitral and tricuspid. The patients who did not present basal severe arrhythmias were submitted to stress testing. We found that in LAH there were great systolic and diastolic dysfunctions, parietal motility alterations and malignant arrhythmias as compared with CRBB. There was no significant difference between LAH and CRBB-LAH. In Chagas disease, the presence of LAH showed much more myocardial damage than in CRBB.