New onset left bundle branch block with right axis deviation in a patient with Wegener's granulomatosis

Left bundle branch block (LBBB) is usually associated with a normal axis or left axis deviation (LAD). When it is seen in association with right axis deviation (RAD) it is felt to be a marker of diffuse advanced myocardial di sease. We report a case of new onset LBBB with RAD in a patient with Wegene r's granulomatosis who had an otherwise functionally and structurally norma l heart. To our knowledge, this is the first case report of LBBB with RAD w ithout severe cardiomyopathy, as well as the first case report of new onset LBBB as a result of Wegener's granulomatosis.