EXERCISE-INDUCED LEFT-BUNDLE-BRANCH BLOCK - A CASE-REPORT OF FALSE-POSITIVE MIBI IMAGING AND REVIEW OF THE LITERATURE

Exercise-induced left bundle branch block is a relatively rare finding during exercise tolerance testing. A 36 year-old female with intermit tent exercise induced left bundle branch block, a MIBI study suggestin g anterior ischemia and normal coronary arteries is reported. A review of the English and French language literature published from January 1985 to January 1996 is presented. Exercise-induced left bundle branch block has been reported in association with and without structural he art disease. Pooled mortality in the group with structural heart disea se was 2.1% per year, and mortality was 0.17% per year when no structu ral heart disease was identified. Exercise-induced left bundle branch block has been reported to resolve with therapy. Noninvasive testing a ppears' to have limited ability to detect or exclude coronary artery d isease in this group. If a definitive cardiac diagnosis is required, s trong consideration should be given to coronary angiography.