Prevalence, clinical and angiography of Coronary Artery Disease in patients with chest pain with left bundle branch block in Iraqi Centers of Heart Disease

Introduction and Aim: Left bundle branch block (LBBB), is seen on the electrocardiograms, when the His-Purkinje system disrupts the normal sequence of activation is changed in the left bundle branch block, leading to specific appearance on the electrocardiograms. Left bundle branch blocks usually occur in patients associated with advanced heart conduction disorders. In this study we aimed to study the prevalence of significant CAD in patients with chest pain and left bundle branches block sent to invasive coronary angiography and study clinical and angiography with distribution of CAD risk factors in our study population.   Methodology:  This investigation is a single center retrospective cohort study that included 400 patients who underwent coronary angiography with left bundle branch block on their ECGs. The study was carried out in the Iraqi Center for Heart Disease between April 2017 and May 2022. Data regarding their age, gender, related risk factors, electrocardiography, echo and left ventricular function was noted. Data was subjected to statistical analysis using the Minitab program.   Results: The prevalence of CAD was 41% among the 400 patients who had LBBB. Demographic data showed age, hypertension, and diabetes mellitus to be a risk factor associated with CAD. The related anatomy of the left bundle branch block in 98 patients showed single or multiple coronary artery disease and likely reduced ejection fraction (<50%).   Conclusion: The prevalence of LBBB is more common in males than in females. The biggest risk factor for cardiovascular disease in those with LBBB and coronary artery disease is hypertension, which is followed by age and diabetes mellitus. Thus, coronary angiography should be used in cardiac tests to identify CAD in individuals with LBBB.