Morte súbita em paciente com bloqueio de ramo direito e elevação persistente de segmento ST / Sudden death in patient with right bundle branch block and persistent ST segment elevation

ABSTRACT

A 43 year old man was admitted to the hospital due to a syncopal episode and presented on the electrocardiogram a pattern of right bundle branch block (RBBB) associated with ST segment elevation from V1 to V4 and normal QT interval. Acute myocardial infarction was suspected but was not confirmed by laboratorial findings. Coronary arteriography was performed and revealed no obstructive disease. No sign suggesting structural heart disease was found. He remained asymptomatic but persisted with RBBB and ST segment elevation. He was discharged from the hospital and was referred to investigation for cardiac arrhythmia as an outpatient, but died suddenly two days later.

RESUMO

Homem de 43 anos, internado por episódio de síncope associado a padrão de bloqueio de ramo direito (BRD) e supradesnivelamento de segmento ST de V1 a V4 no eletrocardiograma e intervalo QT normal. Feita a hipótese de infarto agudo do miocárdio, não foi confirmada nos exames laboratoriais. A cinecoronariografia foi normal. Evoluiu assintomático, porém com persistência do BRD e da elevação do segmento ST. Nenhum sinal de cardiopatia estrutural foi detectado. Recebeu alta com orientação para investigação ambulatorial de arritmia cardíaca, falecendo, porém, subitamente dois dias após a alta