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.