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Thursday, July 24, 2014
Understanding an IRBBB
Today I was diagnosed with IRBBB during a stress test. Another doctor in my doctor`s office did the test at my doctor`s request, after I came in regarding my blood pressure. My doctor did not mention it when he did an EKG when I initially came in a week ago. My systolic has always been alright (110-130), whereas my diastolic has always been high (85-95). A few years ago I began taking Toprol for it and it seemed to work, lowering my diastolic to around 70-75. Recently, however, it has returned to being high (85-95). The same time I started Toprol I started taking Paroxetine for anxiety. So, really it is impossible to determine if it was the Toprol lowering it directly or the Paroxetine lowering it indirectly. I suspect the Toprol didn`t lower it, since my BP went back up about the time I stopped taking Paroxetine. I also am on cholesterol medication (Crestor). My levels are alright since I have been on it. Does this information suggest anything to you?
An IRBBB during a stress test is a nonspecific finding in and of itself. It is hard to say if this is something new, or if you had a IRBBB on a previous ECG, without a prior ECG to compare it to. Even if it developed with exercise, it is a common finding when the heart rate increases. Perhaps you could discuss it with your doctor to see if this is something that was seen on prior resting ECG's.
Karen Kutoloski, DO
Assistant Professor of Medicine
School of Medicine
Case Western Reserve University