Pulmonary embolism (PE) is a notorious life-threatening condition. It is currently the third most common cardiovascular cause of death worldwide, after myocardial infarction and stroke (1). Recognized as an entity two hundred years ago, it will very likely continue to retain its grim statistics for centuries to come.

Objective: Isolated complete right bundle branch block (CRBBB) is a known ECG finding in apparently healthy adults. However, the etiology of CRBBB is studied poorly and its prognosis still debatable.
We aimed to demonstrate speckle-tracking imaging findings in a patient with CRBBB.
Case presentation: An apparently healthy lady was found to have a CRBBB on an incidental ECG. Routine echocardiography showed normal cardiac anatomy and function. Speckle-tracking echocardiography depicted preserved global strain of the left ventricle with depressed peak systolic strain of septal apical and mid-septal segments. We present a focal myocardial insult in the area corresponding to the anatomy the right bundle of His. Such correlation may explain the CRBBB present in the otherwise healthy patient.
Conclusion: Speckle-tracking echocardiography in complete right bundle branch block may help to identify the etiology of this conduction disturbance and assist in making the prognosis.