home Adviсe Complete AV block code according to ICD 10. According to the anatomical structure of the block. Causes of bundle branch block

Complete AV block code according to ICD 10. According to the anatomical structure of the block. Causes of bundle branch block

Bundle branch block (BNBB) is a disorder of intracardiac conduction caused by damage to the His bundle. Diagnosis of pathology is carried out during instrumental research by taking an electrocardiogram. The disease manifests itself as abnormalities heart rate, dizziness, development of syncope.

What is a bundle branch block?

Bundle branch block is a partial/complete disruption of the passage of an electrical impulse through the conduction system of the heart. In cardiological practice it is not distinguished in independent illness, but is considered as a sign of existing heart disease. Found in 0.6% of the population, much more often in men. The frequency of diagnosis increases with age.

Reference! The ICD-10 code depends on the area of damage.

Causes of bundle branch block

There are quite a lot of factors that provoke the development of the condition.

The causes of RBBB (right bundle branch block) are:

hypertonic disease;
pathological enlargement of the right heart;
ischemic disease hearts;
sarcoidosis;

Causes of LBBB (left bundle branch block):

heart attack;
myocarditis;
endocarditis;
cardiosclerosis;
calcinosis.

Important! The provoking factor of double-bundle blockades is narrowing/absolute closure of the aorta and other aortic defects.

In addition to the previously discussed reasons, the following can provoke RBBB:

cardiopathologies - rheumatism, heart failure, etc.;
changes in electrolyte levels;
long-term use, in particular;
influence of toxic components;
diseases of endocrine origin, for example, high blood sugar;
a constant lack of oxygen in the body, caused, in particular, by asthma.

Characteristics and symptoms of each type of RBBB

Each variety has its own typical symptoms and clinical picture.

Right bundle branch block (RBBB)

The causes of focal RBBB are directly dependent on the existing form of conduction disturbance. The background for the primary blockade is:

taking antiarrhythmics of classes 1A and 1C;
electrolyte balance deviations;
injury to the chest area;
formation of blood clots in the lumen of the pulmonary artery;
myocarditis, etc.

Important! RBBB is a typical complication accompanying the post-infarction state. Especially if the changes affected the right ventricle of the heart or the posterior wall.

RBBB accompanies the following diseases:

valve system defects;
organic damage to myocardial cells.

In approximately 20% of all diagnosed cases, detect the real reason the development of the condition fails.

Left bundle branch block (LBBB)

A characteristic of complete blockade of LBP is the absence of propagation of excitation to the point of divergence of the leg. The occurrence of a two-bundle blockade cannot be ruled out; both branches are excluded from the process.

NBPBP (not complete blockade right bundle branch) is accompanied by slow impulse conduction. Excitation of the myocardial cells of the left ventricle occurs due to impulses passing through the right branch of the His bundle.

Symptoms of blockade of the anterior branch of the left bundle branch (ALBBB)

The state of blockade of PVLNP in most cases occurs unnoticed by the patient. Diagnosed accidentally during a cardiogram. ECG signs are a shift of the QRS electrical axis to the left and the appearance of pronounced R (up) and S (down) waves.

Very rarely, the condition is accompanied by the development of arrhythmia, but it should not be considered as a characteristic clinical symptom.

Block of the posterior branch of the left bundle branch (LPBLB)

In case of complete blockade of the zone, it does not participate in excitation processes. There are no characteristic signs.

Double-bundle BNPG

In the two-fascicle form, the posteroinferior zone of the left ventricular myocardium is first excited. Then the spread to the anterolateral sections and further, to the myocardial tissue of the right ventricle is recorded.

The pathology is clearly visible on the ECG and is expressed in the expansion of the QRS complex and some other changes.

Important! Diagnosis of combined blockade indicates serious changes in the myocardium.

Three-bundle BNPG

In the incomplete form, the transmission of the exciting impulse occurs along a less damaged branch and is accompanied by the development of the first/second degree.

With complete blockade, the passage of excitatory impulses along the atrium-ventricle path is completely stopped. This is expressed in the disunity of rhythms. Ventricular contraction occurs in an idioventricular arrhythmic mode, which also acts as asystole.

Symptoms of bundle branch block

Most cases of blockade are completely asymptomatic. In particular, this applies to incomplete single-bundle blockade. The condition is diagnosed completely by accident during a planned cardiac cardiogram.

But clinical symptoms complete blockade of the right leg is recorded in the patient even when signs organic damage his heart was not identified. Signs of pathology are:

changes in the functioning of the heart muscle;
development of dizziness;
syncope and presyncope;
intolerance physical activity;
increased fatigue, general weakness;
pain in the heart area and a feeling of interruptions in its work.

Development is possible clinical picture, reflecting the underlying pathology. This may be a cardiological profile, or diseases of other organs and systems.

Severe symptoms accompany the following complex cardiac pathologies:

heart failure;

They are accompanied by the development of various forms of heart block with damage to the ventricular myocardium.

Right bundle branch block in children

The child has pathological condition can be formed during the period of intrauterine development, i.e. during a woman’s pregnancy. But it can also be acquired against the background of a previous heart disease. vascular systems s.

The reasons can be:

insufficient blood supply - the resulting oxygen starvation can cause the development of myocardial ischemia;
death of the His bundle - a state of hypoxia can provoke the death of myocardial cells and their replacement with non-functional scar tissue;
heart failure;
pathologies of the heart muscle caused by its organic damage;
abnormal structure of the heart - intrauterine development disorders;
inflammation of myocardial tissue;
heart surgery;
autoimmune pathology - can provoke disruptions in the functioning of the myocardium;
pathological increase in blood pressure - in childhood can cause changes in the structure of the heart, in particular, provoke the development of LVH (), which is accompanied by a violation of its functionality.

Reasons congenital blockade speakers:

multifocal damage to connective tissues in a pregnant woman;
insulin-dependent form of diabetes;
abnormal development of the right bundle branch;
disturbance in the structure of the partitions in the heart cavity.

The condition can develop as a result of a closed heart injury. It could be:

a blow to the chest during a fall or push;
incorrectly performed medical procedures during surgery on the heart muscle.

The primary symptoms are:

loss of consciousness and presyncope;
attacks of dizziness;
periodic development of bronchospasm;
fatigue and unexplained weakness;
heart attack;
oxygen starvation of brain cells;
general development lag;
enlargement of the left ventricle and atrium;
angina attacks;
heart defects.

Diagnostics

Diagnosis of pathology in patients in adulthood and childhood is based on instrumental tests and analyses. This:

general and biochemical blood test;
examination of the patient's urine;
establishment hormonal status- helps in determining the causes of the disease that are not associated with impaired functionality of the heart and blood vessels;
taking an electrocardiogram - helps to obtain a description of the existing deviations and determine the form of the blockade;
Holter (24-hour) monitoring - helps to identify existing conduction disorders;
taking an ECG after stimulating the myocardium with an electrical impulse;
EchoCG - used to determine the root cause of the block.

Interpretation of the results obtained is within the competence of the specialized specialist and helps him select the necessary treatment.

Treatment for bundle branch block

There is no specific treatment for the pathology. Since RBBB is only a symptom, doctors treat the underlying disease that caused the blockade to develop.

If the condition was provoked by hypertension, angina pectoris or heart failure, then the treatment protocol for the patient is prescribed to take the following medications:

products from the nitrate group;
cardiac glycosides;
medications that stabilize blood pressure.

It is recommended to treat the condition by installing a pacemaker when AV block develops.

In the case of an asymptomatic course, the patient is prescribed clinical observation.

Lifestyle with bundle block

If the patient’s well-being is not overshadowed by the development clinical manifestations pathological cardiac condition, he can live as usual, without limiting physical activity. There are no other contraindications.

When identifying two- and three-fascicular blockades, the following recommendations must be observed:

limitation of physical and psycho-emotional stress;
frequent rest;
proper nutrition;
quitting smoking and alcohol.

If a pacemaker is installed, the patient must carry a pacemaker card with him. In addition, during a conversation on cell phone The tube should be applied not to the left, but to the right ear.

A control ECG is taken once a year. The procedure can be performed more often if the attending physician sees a need for it.

Complications

Complications of any type of blockade can include:

ventricular fibrillation - cardiac arrhythmia, characterized by asynchronous contraction of the ventricles;
full .

A complete blockade of the leg of His can provoke the following complications of the underlying disease:

development of heart failure - the inability of an organ to provide adequate blood supply to the body;
blocking the lumen of the vessel with detached particles of the thrombus.

Prevention of the formation of pathology comes down to timely elimination of diseases, systematic visits medical institution, compliance with all prescribed recommendations. This is especially important for people with diagnosed diseases of the heart and vascular system

Forecast

As a result, it should be noted that His bundle block is only a symptomatic sign of cardiac pathology, but not a disease. It is detected during a cardiogram or based on a patient interview.

The general prognosis of the condition largely depends on the root cause, i.e., the disease that acted as a provoking factor for this disorder.

With a single-bundle right-sided blockade against the background of the absence of cardiac and pulmonary complications the prognosis is good.
Complete blockade of the left leg in combination with necrotization of myocardial cells receives bad prognoses from doctors. Mortality in acute period reaches 50%.
Three-bundle blocks also have poor prognosis for outcome. There is a high probability of asystole formation and subsequent death of the patient.

Bundle branch block is a pathological cardiac condition that requires medical monitoring. That is why during the development unpleasant symptoms It is recommended that you seek medical advice.

Synonyms

Atrioventricular blockade.

Definition

AV block is a violation of the conduction of impulses from the atria to the ventricles of the heart at the level of the AV junction.

ICD-10 code

I44.0 Atrioventricular blockade of the first degree.

I44.1 Atrioventricular block of the second degree.

I44.2 Atrioventricular block is complete.

I44.3 Other and unspecified atrioventricular block.

Prevention

There are no specific preventive measures. Preventive actions should be aimed at preventing diseases accompanied by the development of AV block.

Screening

No special screening is carried out. To identify the disease within dispensary observation and preventive examinations, you can use ECG registration in 12 standard leads, as well as Holter ECG monitoring.

Classification

There are congenital and acquired AV blocks. Depending on the nature of the occurrence, acute, intermittent (transient) and chronic (permanent) AV blockades are distinguished, and depending on the level of impulse conduction disturbance - proximal (impulse conduction block above the trunk of the His bundle) and distal (level of block below the trunk of the His bundle) .

Depending on the severity of AV conduction disorders, there are:

1st degree AV block - prolongation P-Q interval on the ECG more than 0.2 s.

Second degree AV block:

Mobitz type I - a progressive increase in the duration of the P-Q interval, which ends with the loss of the QRS complex with subsequent resumption of conduction (Samoilov-Wenckebach period) (Fig. 1);
Mobitz type II - sudden (without previous prolongation of the P-Q interval) loss of the QRS complex (see Fig. 2).
High degree AV block (far advanced) - loss of two or more ventricular complexes, or AV block with 2:1 conduction (Fig. 3, 4).

III degree AV block (complete AV block, complete transverse block) - lack of impulse conduction from the atria to the ventricles.

Rice. 1. Atrioventricular block of the second degree, types I and II. ECG - signs acute phase myocardial infarction of the lower wall of the left ventricle (elevation of the ST segment in leads II, III, aVF with reciprocal depression in the chest leads). In standard leads in the 2nd and 3rd complexes, a progressive lengthening of the P-Q interval is recorded with loss of QRS after the next P wave (Mobitz I). The loss of QRS after the 1st complex in standard and the 1st and 2nd complexes in the chest leads is not preceded by P-Q prolongation (Mobitz II).

The disease is a disorder of the conduction of electrical impulses through the His bundle (RBBB).

1st degree AV block code according to ICD 10 I44 (international classification according to the approved medical classifier) is one of the most common heart rhythm disorders among people of all age categories; the risk of getting sick increases with age.

Men are especially at risk; women suffer less.

Pathogenesis of the disease: excitation of one half of the interventricular septum and the right ventricle occurs atypically.

The impulse takes over the left ventricle and left half interventricular septum and along the LNPG reaches the muscle of the right ventricle. The conduction of the impulse is difficult along the PNJ.

Experts divide the causes of BLNP into organic and functional according to the code classifier.

Functional reasons:

a drop or rise in potassium levels in the blood;
overdose of cardiac glycosides;
improper use of medications.

Organic causes of PNH blockade:

Conduction disorder classification:

Clinical picture

The disease is generally asymptomatic and therefore early stages difficult to detect.

However, there are changes physical condition and symptoms that may indicate the disease.

First signs:

heart failure;
pain on the left, in the chest area;
fainting state.

Diagnostic measures

A specialist can make the correct diagnosis. To identify the disease, an ECG or Holter monitoring is used, which is a daily recording of the heart’s work.

Band block is characterized by an increase in the duration of the QRS complex and its splitting.

The examination group includes lab tests, as well as angiography, x-ray and echocardiography.

Features of the course in children

Right bundle branch block in children is congenital and is often accompanied by CHD:

cardiac hypotrophy;
valve defects;
overload of the right side of the heart;
cardiac septal defects.

Risk group

As mentioned above, middle-aged and older men are at risk. In children, incomplete blockade is not dangerous if there are no complex heart defects and the hemodynamics of the body are not impaired.

Patients who take a large number of medications, mainly antiarrhythmics, partially or completely disrupting the transmission of impulses through the His bundle.

Lung diseases, such as pulmonary hypertension, can also cause disruption.

Impulse disturbance as a complication is of concern in cardiosclerosis, valvular insufficiency and right ventricular hypertrophy.

Treatment of nbpng

In case of conduction disturbance, the disease that caused it is treated first. Congenital heart defects are corrected surgically.

Drug treatment is carried out for diseases such as heart failure, angina pectoris, hypertension.

Patients are prescribed cardiac glycosides, antihypertensive drugs, and antiarrhythmics.

If incomplete blockade is considered normal, then medications are not prescribed; patients are regularly examined and are advised dietary food and moderate physical activity.

For surgical treatment the patient is hospitalized in the clinic. This is necessary to carry out full examination and making decisions regarding treatment tactics.

As a rule, surgery is prescribed in the most severe cases, medical interventions are mainly aimed at treating the underlying cardiac disease.

Complex therapy helps improve the prognosis and significantly prolong a person’s life.

If there is a threat of an incomplete blockade developing into a complete one, patients are recommended to undergo cardiac stimulation.

ethnoscience

In the absence of complications, it is advisable to supplement drug therapy with traditional medicine. Below are some healthy recipes.

Regarding the use of plants, consultation with a cardiologist is necessary; not all herbs can be combined with pharmaceutical medicine.

Helps restore health after stroke and heart attack, improves physical condition and improves tone. To make an aqueous infusion of jaundice, you need to take a teaspoon of dry raw material and pour a glass of boiling water.

Drink one teaspoon three times a day; if atrial fibrillation bothers you, the dosage is increased to a tablespoon at a time.

Used for treatment alcohol infusion, for the preparation of which they take twenty grams of dry raw materials and one hundred milliliters of alcohol.

Jaundice is infused in alcohol for two weeks, after which it is filtered and ten drops are taken in water before meals. The course of treatment is six months. Alcohol infusion should not be given to children.

Hazel

Hazel tea is a gentle sedative that enhances the effectiveness of cardiac medications. Tea is made from hazel leaves or bark.

A tablespoon of the dry mixture is poured into a glass of boiling water and left for thirty minutes. Drink tea twice a day, half a glass.

sedum

Contains substances that help with blockades varying degrees gravity. To prepare tea, take a teaspoon of dried herb and pour a glass of boiling water. This glass must be drunk within 24 hours.

Sports and the military

Incomplete blockade does not prevent sports activities in at a young age, when serious training cardiologists recommend undergoing Holter monitoring to determine the physical condition of the athlete.

If the conduction disorder does not progress, then there are no obstacles to serious training; a person must undergo an ECG examination every year to analyze the functioning of the ventricles.

Young men are drafted into the army with the mark “fit for service with minor restrictions.” This means that he will be taken into the infantry or signal troops.

Small restrictions mean the branch of the military; in the army there will be no other restrictions. IN elite troops such a young man will not get in.

Preventative care measures

In case of violation electrical conductivity in incomplete cases, treatment is not necessary. The patient undergoes examination and mandatory ECG every year.

When pain occurs in chest, weakness, dizziness, you should immediately consult a doctor for advice.

It is important to remember that the development of an incomplete form into a complete one can lead to fatal outcome, so you need to monitor your condition.

It is advisable to always carry with you medical card and have the cardiologist’s phone number with you.

A correct lifestyle, lack of stress, sleep and rest patterns are important. Preventive measures are aimed at timely treatment emerging diseases, taking all necessary vitamins and restoratives.

Patients with blockades are advised spa treatment in specialized sanatoriums, mud therapy, massages and walks on fresh air.

Sea bathing under the supervision of specialists is also prescribed. In places where there is no sea, they take baths with sea salt.

The diet in such sanatoriums is calculated individually; the diet depends on the diagnosis and characteristics of the person’s disease. Obese people are helped to lose weight by reducing the calorie content of meals.

Prevention measures for children include massages, physical therapy, rational nutrition and sanatorium treatment.

Children with incomplete blockades should not be protected from life; they can attend school and kindergarten on a general basis; they are not exempt from physical education lessons unless there are serious violations.

Long walks in the fresh air are beneficial at any time of the year. Vaccinations are given according to the general schedule; exemptions from vaccinations are not given.

Children with conduction disorders in the His bundle are registered with a cardiologist and undergo an annual examination to identify emerging problems.

If a child experiences weakness, dizziness, or pain, parents should immediately contact their doctor. The telephone numbers of a specialist and an ambulance should always be at hand.

During peak periods viral infections the child is protected from visiting crowded places, since the flu causes severe complications leading to complete violation passage of impulse and disability.

If symptoms such as cough or runny nose appear, you should immediately show your baby to a doctor to avoid serious consequences.

Speaking about prevention, it is very important not to forget about nutrition, especially for children. It must be high in calories and contain everything essential minerals and vitamins. In the off-season, it is recommended to take pharmacy vitamin complexes.

Very fatty, heavy foods and store-bought foods are excluded from the diet. Fresh fruits, herbs, vegetable salads, milk and sour milk should be present in the child’s diet every day. Important correct mode sleep and wakefulness, study and rest.

Significant: teaching a child the basics the right image life and rational nutrition, since they live with a cardiac diagnosis all their lives.

Sinoatrial(SA) blockade- pathological slowing or disruption of the output of the impulse from the sinoatrial node to the atria. Prevalence - 0.16-2.4%. The predominant age is over 50-60 years.

Code according to the international classification of diseases ICD-10:

I45.5

Diagnostics

ECG - identification. There are three degrees of SA blockade. I degree - slowing of sinoatrial conduction. Diagnosis is made only through electrophysiological studies by determining the SA conduction time. II degree - blocking the exit to the atria of one or more sinus impulses in a row. Diagnosed using a standard ECG.. Type I (with Wenckebach periodicity)... frequency of automatic discharges in sinus node remains constant... the extended P-P interval (pause), however, it is shorter than twice the P-P interval preceding the pause... after a long pause, a gradual shortening of the P-P intervals is observed... the first P-P interval after the pause is longer the last P-P interval preceding the pause.. Type II - sudden blocking of one or more sinus impulses without the preceding Wenckebach periodicity... the pause is equal to double, triple, etc. R-R interval... systematic SA - 2:1 blockade simulates sinus bradycardia; stable SA - blockade 3:2 is mistakenly interpreted as atrial bigeminy.. III degree (complete). Recognized only by electrography of the SA node. The ECG usually records an atrial ectopic rhythm, a slow replacement rhythm from the atrioventricular junction (rarely from the ventricles), and atrial fibrillation.

Symptoms (signs)

Clinical manifestations. At low heart rate - symptoms of sinus bradycardia. With advanced SA blockade, Morgagni-Adams-Stokes attacks are characteristic - see Sino-atrial node weakness syndrome.

Differential diagnosis. Sinus bradycardia. Sinus arrhythmia. Atrial extrasystole (compensatory pauses).

Treatment

Treatment. See Sick sinus syndrome, Morgagni-Adams-Stokes syndrome.

Reduction. SA - sinoatrial.

ICD-10. I45.5 Other specified heart block

Bundle branch block is a hindrance or obstacle to the normal passage of the sinus impulse through the cardiac conduction system. Such an impulse is formed in the sinus node, goes beyond its boundaries, enters the atrium system and excites both atria as it passes. During its passage, the sinus impulse undergoes a considerable physiological delay, reaching the atrioventricular junction and entering the small conduction system of the ventricles.

Features of the disease

Left or right bundle branch block - dangerous disease, associated with a violation of the conduction of cardiac impulses necessary for normal heart function.

Very rarely, the disease is diagnosed in young people and the general figures range from about 0.1% of known cases.
The older the person, the more often this disorder is diagnosed.
At age 40, the percentage is already 4.5%.

ICD-10 codes:

Intraatrial blocks:
- I45.8 Other specified conductivity faults.
Intraventricular blocks:
- I44.4 Block of the branch of the (anterior) left bundle branch.
- I44.5 Block of the branch of the (posterior) left leg.
- I44.7 Left leg block, unspecified.
- I45.0 Right leg block.
- I45.2 Double bundle block.
- I45.3 Trifascicular block.

Types and forms

According to the anatomical structure of the blockade

By anatomical structure His bundle blockades are divided into:

single-beam;
two-beam;
three-beam.

Single-bundle blockades affect only one leg: blockade of the right leg, the left anterior leg and the left posterior leg. Double-bundle blockade - when 2 branches of the His bundle are affected simultaneously (branches of the posterior and anterior left legs, right legs and left anterior branches, branches of the posterior left and right legs). Three-bundle blocks - damage to all three branches of the His bundle.

According to the degree of impulse conduction disturbances

Blockades of the legs of His are also divided according to the degree of impulse conduction disturbances:

incomplete;
full.

Incomplete blockade is a violation of the passage of impulses along one branch of the His bundle. In this case, the function of the second leg or branch is not impaired. Excitation of the ventricular myocardium in this case occurs more slowly than it should, and is provided by healthy branches.

When the impulse passes through the branches at a slow rate, it is called incomplete 1st degree heart block.
In the case when only some impulses reach the ventricles, heart block of the 2nd degree (incomplete) occurs.
3rd degree block or complete block is defined as the complete inability of cardiac impulses to pass into the ventricles. Because of this, the latter contract independently, at a speed of 20 to 40 beats per minute.

Even more useful information on the issue of incomplete bundle branch block is contained in the following video:

By duration

Leg blocks are:

transient (intermittent);
permanent (irreversible).

In rare cases, disturbances in the transmission of impulses begin to develop with changes in heart rate. For example, with tachycardia or bradycardia.

Causes

Provoking factors for His bundle conduction disorders include:

previous myocardial infarction;
heart valve defects;
hypertonic disease;
chronic diseases respiratory tract with obstruction;
blunt chest trauma;
neoplasms on the heart;
progressive muscular dystrophy;
overdose of certain medications;
myocardial pathology;
high potassium levels in the blood.

Hereditary factors:

stenosis of the mouth of the pulmonary artery;
defective development of the segment of the right bundle branch;
defects of the interventricular and interatrial septa;
heart defects leading to increased load on the right ventricle.

Symptoms

Incomplete isolated blockades of the right and left bundle branches have little effect. It may be detected incidentally using an ECG. Clinical symptoms of the disease can manifest themselves only with complete blockade of the right leg. In a third of patients, signs of disturbance during routine cardiac listening may be observed.

TO possible symptoms include:

dizziness, lightheadedness, fainting;
fatigue, weakness;
shortness of breath and lack of air.

The diagnosis is made based on the patient’s complaints, examination and listening to the heart. An ultrasound of the heart and an ECG are required to identify complete or incomplete blockade of the left or right bundle branch. The examination does not make it difficult to establish a diagnosis; such disorders are revealed by a comprehensive examination of the patient.

Read on to learn more about treatment methods for complete or incomplete blockade of the right/left bundle branch.

The following video will tell you more about how an ECG occurs in the case of right/left bundle branch block:

Treatment

Blockage of the left (right) leg usually does not imply any treatment. The emphasis is on the disease that provokes such disorders.

Medication

Prescribe vitamin and restorative medications, a diet excluding sugar and fats. The emphasis in food is on eating fresh vegetables and fruits.

In the event that cardiac conduction disturbance is complicated by angina pectoris, heart failure, arterial hypertension, therapy is carried out using:

nitrates;
cardiac glycosides;
antihypertensive drugs.

Surgical

It is produced in the ineffectiveness of drug therapy and with frequent fainting, as well as in malignant processes.

In case of AV blockade, indications for pacemaker implantation can be considered. In case of His bundle block, which occurs without obvious clinical manifestations, dynamic observation.

Prevention

Preventive measures include:

daily routine, full and restful sleep;
refusal of fried, canned and spicy foods;
consumption of foods with a significant fiber content: fresh fruits and vegetables, herbs;
avoidance of stressful situations;
giving up alcohol and smoking;
taking medications only prescribed by a doctor and under his supervision;
timely diagnosis and treatment of diseases of all organs, not just the heart;
mandatory consultation with a doctor if symptoms of the disease appear.

Read on to learn about the consequences of complete and incomplete blockade of the right/left bundle branch.

Complications

The main consequences of the disease include:

sudden death;
myocardial infarction;
stroke;
worsening of the disease that provoked the blockade;
heart failure;
thromboembolic disorders.

Below you will find the prognosis for complete or incomplete right/left bundle branch block.

Forecast

In young people without serious organic diseases of the cardiac and vascular systems, the prognosis is favorable. It is known that an isolated blockade of the right leg will never develop into a complete blockade.

The overall prognosis will depend on the underlying disease. In turn, such a violation of cardiac conduction adds risks sudden death, as well as the development of various long-term complications. Development of AV block, heart failure, conduction defect, arterial hypertension and cardiomegaly also increases the risk of an unfavorable outcome.

To all parents whose children have undergone right/left bundle branch block and others concomitant diseases The following video is worth watching:

gidmed.com

In the case of such a disease, the conduction of electrical impulses along the right leg worsens or stops. At the same time, on left leg pathological processes do not spread and impulses are carried out fully, albeit with a delay. Intact branches provide excitation of the ventricular myocardium, but the transmission process is slow.

In this case, a disorder such as incomplete heart block of the 1st degree occurs. However, even passing through an intact bundle branch, not all impulses can reach the ventricular myocardium. This indicates the development of incomplete heart block of the 2nd degree.

If impulses from the atria do not pass to the ventricles, then this condition is characterized as a complete block of the bundle branch. Separately, isolated incomplete blockade of PNPG is distinguished. The causes of the latter remain unknown.

Any of the situations described can only be identified using instrumental diagnostics. Patients with symptoms of this disease are prescribed mandatory electrocardiography. How does incomplete blockade of PNPG appear on the ECG?

The bundle branches are the conducting element of the cardiac system, responsible for conducting electrical signals through the ventricles of the heart. The bundle of His consists of three separate parts:

posterior bundle branch;
right anterior and left anterior limb of His.

Bundle branch block is an intracardiac conduction disorder characterized by complete cessation or slowing of the conduction of the excitation impulse along several or one of the branches of the His bundle.

In addition, this violation can only occur when:

instrumental research methods;
symptomatic heart rhythm disturbances;
attacks of loss of consciousness;
frequent dizziness.

Similar symptoms of the disease are most characteristic of incomplete blockade of the right bundle branch. Diagnosis of blockade of the His bundles is carried out using electrocardiography methods.

Treatment of this disorder can be reduced to eliminating the main causes of the disease (electrical conductivity disorders).
In some cases, it is possible to install an artificial heart pacemaker.

Incomplete blockade of the right bundle branch is a variant of the norm, when the heart impulse travels along a longer path of propagation, while, in any case, achieving its specific goal.

As a comparison, let’s give one specific example: when approaching any building, you can walk around or in a straight line, still achieving your final goal (to go through open doors). However, in the first case, your path will be a little shorter, and in the second, a little longer.

Right bundle branch block does not require any special treatment methods. You should not feel any anxiety about this. A completely different situation can be observed with blockade of the left bundle branch, since this disorder is very serious and requires active therapy from a cardiologist. The bundle branches are responsible for regulating the rhythms of the heart.

Incomplete right bundle branch block is a common disorder of intraventricular conduction, occurring mainly in middle-aged and older people. Common reasons of this pathology are various diseases, leading to organic damage to the heart muscle, such as coronary heart disease, essential hypertension (hypertension), rheumatic defects and many others.

However, in some cases, incomplete blockade of the right His bundle is detected in relatively healthy individuals, which indicates a previous heart disease (myocarditis and others) rather than the functional nature of the conduction disorder.

Right bundle branch – the most important part the conduction system of the heart, which ensures the conduction of electrical impulses to the myocardium of the right ventricle. Incomplete block of the right bundle branch leads to impaired excitability and, accordingly, contractility of this part of the heart, which, however, is not accompanied by any significant symptoms and hemodynamic changes.

In itself, partial blockade of the right bundle branch does not require specific treatment, however, it serves as a factor that aggravates the course of the underlying cardiac disease, which necessitates the need for correction of therapy.

As a rule, the blockade develops against the background of heart disease. Conduction disorders inside the heart ventricle are often caused by necrotic, sclerotic, and inflammatory processes. In addition, the cause may be those pathological processes that lead to a state of overload of some parts, in particular the ventricle.

Such diseases include heart defects (congenital, in which there is an excessive load on the right ventricle, defects of the septa between the atria and ventricles), mitral stenosis, coronary heart disease, acute conditions (heart attack), arterial hypertension and cardiosclerosis.

The causative factors for the development of an incomplete type of blockade are intoxication or overdose medicines(from the group of digitalis, adrenergic blockers), disturbances in electrolyte metabolism. Due to the development of the blockade, the conduction of impulses through the heart system slows down, which leads to the fact that physiological, full excitation of the right sections does not occur.

The diagnosis of blockade separately at the level of the right leg can only be established on the basis of an electrocardiographic study. When deciphering the ECG, changes in the QRS complex are detected (expansion and jaggedness of its terminal part), while the duration of the complex itself is usually increased.

In the chest leads, the R wave will be enlarged and jagged, the ST segment will be lowered. Which congenital causes exist:

violations of the interatrial septum;
congenital heart defects that overload the right ventricle;
M.Lev disease (unexplained etymology);
ventricular septal defects;
Legere's disease (cardiac conduction disorders in children);
arterial stenosis of pulmonary vessels;
underdevelopment of the right bundle branch.

Acquired reasons:

progressive pathologies in sarcoidosis (myocardium and the like);
overdose of novocainamide, quinidine, cardiac glycosides;
increased potassium levels (hyperkalemia);
muscular progressive dystrophy;
cardiac neoplasms;
blunt trauma to the sternum;
obstructive chronic pulmonary diseases.

Incomplete blocking of the right bundle branch is a partial disruption of electrical impulse transmission along the right bundle branch.

Incomplete blockade of the right bundle branch, as not subject to treatment, poses absolutely no threat to the life of a pregnant woman. Even if the disease progresses, only it needs to be treated.

Who is at risk

Various types of right leg blockades, as shown medical statistics, most often occur in men. Blockades of the left leg, on the contrary, are most common in women aged 50 to 70 years who suffer from hypertension.

The older a person is, the more likely it is that the disorder he develops in the transmission of cardiac impulses will have its full form.

In children, incomplete blockades of the right leg are not uncommon, but this deviation does not pose a danger to the child’s health if he does not have cardiac pathology or disturbances in the functioning of the cardiovascular system and respiratory organs.

Even if incomplete blockade is asymptomatic, it affects the functioning of the ventricles. Therefore, when predicting the development of any type of blockade, the condition of the ventricular tissues is certainly taken into account.

There is a whole list of diseases that can provoke the occurrence of incomplete blockade of the right bundle branch of His. Complete and incomplete forms of the disorder can be congenital or acquired. Is the blockade inherited?

Controversial issue. Today it is generally accepted that it is not transmitted, but a predisposition to problems with the transmission of electrical impulses in an internal organ can still be inherited. The following can provoke the occurrence of incomplete blockade of the right leg:

congenital and acquired heart defects;
ischemic disease;
stenosis;
heart failure;
myocardial infarction.

An overdose of drugs entails various disorders in the functioning of internal organs, renal and liver failure. IN medical practice There are often cases when medications used against arrhythmia cause complete or partial disruption of the transmission of electrical impulses in the heart.

Pathologies of the lungs also have an impact on the heart. If a person is diagnosed with, for example, pulmonary hypertension, there is a high probability that it will cause the appearance of a complete or incomplete form of leg block.

Acute myocardial infarction and cardiosclerosis are favorable conditions for disturbances in the conduction of electrical impulses. Tricuspid insufficiency can produce a similar result. heart valve and right ventricular hypertrophy.

The general condition of the body and destructive changes in the functioning of internal organs are closely interrelated. When the balance of electrolytes in the body is disturbed, conditions are created for the occurrence of bundle branch blocks.

When the violation becomes acute, it is required drug therapy. But there is another important point here: all the drugs that the modern medicine, are capable of producing a temporary effect, and treatment of the blockade with them can lead to unpredictable consequences, including aggravation of the pathological condition.

Blockade of any of the bundle branches is characterized by a persistent or transient form. In the second case, the state of blockade can either disappear or appear, but intraventricular conduction will remain the same.

There is also an alternating form of partial disruption of the transmission of electrical impulses in the heart, when the state of blockade is observed alternately on one or the other leg. Symptoms of blockades are quite difficult to detect. This is due to two main reasons:

most blockades are asymptomatic;
the disturbances in the functioning of the heart they cause are characteristic of existing pathologies internal organ.

Abnormalities in heart rhythm and heart rate are inherent in many heart diseases, but with incomplete blockades these symptoms are not observed.

If the blockade of the branch of His is not partial, patients may complain of dizziness, clouding of consciousness, and that it often becomes difficult for them to breathe. All these are consequences of impaired transmission of cardiac electrical impulses, but they are typical for various pathologies internal organs, including the lungs.

It is necessary to carry out diagnostics to check the condition of the legs of His when a person, for no apparent reason, often begins to feel increased fatigue and an unreasonable decrease in performance.

It is important to know: a clinical analysis of blood and urine cannot help determine deviations in the transmission of impulses. To detect a disorder, it is necessary to undergo a hormonal status examination and Hotler ECG monitoring. The latter method is unique in that it allows one to detect complete and incomplete disruption of the transmission of electrical impulses in an internal organ.

This type of ECG allows doctors to record changes that entail different kinds blockades Differentiating clinical symptoms of cardiac pathologies and pathological abnormalities is a rather difficult issue, especially when disturbances in the functioning of an internal organ have typical and atypical symptoms.

Holter ECG monitoring makes it possible to determine in each specific case clinical symptoms at the time of the blockade attack. Indispensable conditions for effective diagnosis are the simultaneous recording of the patient's sensations and monitoring of clinical symptoms.

This information is of particular value when doctors determine the cause of disturbances in the transmission of electrical impulses. Classical ECG is also widely used to diagnose blockades. To perform a traditional ECG, the transesophageal method is used.

It is one of the most informative ways. During such a diagnosis, sinus arrhythmia, characteristic of incomplete blockade of the right bundle branch, is also determined.

She must not be disturbed. This rule applies to incomplete blockade of the right leg, which is not as dangerous as disorders that occur on the left. Treatment partial blockade required:

if its appearance coincided with an exacerbation of heart disease;
when in parallel there is a blockade of the left leg.

In such cases, restore normal functioning internal organs are helped by cardiac stimulation methods. If an elderly person develops an exacerbation of cardiac pathology that coincides with any form of right leg block, he requires urgent hospitalization.

When the patient's condition worsens with progressive cardiac pathology and incomplete blockade, drug therapy is used.

In such cases, doctors prescribe the patient to take anticholinergic drugs, drugs that enhance the effect of symptoms on the cardiac conduction system, glucocorticosteroid hormones, and drugs that reduce potassium levels in the body.

All of them are usually administered intravenously. They are not able to completely cure the blockade, but they can restore the transmission of electrical impulses. The prognosis for blockade therapy is usually favorable if the risk of worsening the concomitant cardiac pathology is excluded or minimal.

Clinically, incomplete blockade of the right branch of the His bundle does not manifest itself in any way. In most cases, pathology is detected by chance during a routine preventive electrocardiographic examination.

Due to the fact that disturbances in impulse conduction inside the ventricles most often occur against the background of organic damage to the heart, patients with this pathology may present “cardiological” complaints, such as:

Retrosternal pain.
Dyspnea.
Swelling in the legs.
Increased blood pressure.
Cyanosis of mucous membranes and skin(bluish tint).

In some rare situations, incomplete blockade of the right side of His can be accompanied by a decrease in heart rate to 55-60 beats per minute or lower, which is due to the redistribution of the excitation wave along the conduction system of the heart and the relative activation of Purkinje fibers, which transmit impulses from the branches of His to the cardiomyocytes themselves.

It should be noted that, despite such frightening reasons, usually incomplete blockade of the right leg is completely benign. Moreover, with isolated incomplete blockade of the right leg, that is, in the absence of organic disorders in the myocardium, the process extremely rarely turns into a complete blockade.

Isolated incomplete blockade of the right bundle branch does not manifest itself in any way and, as a rule, is an accidental finding during an ECG for completely different reasons, for example, during a routine medical examination or a medical examination before conscription into the army.

In other cases, there will be symptoms of the underlying disease, since incomplete blockade of the bundle branch itself does not have any symptoms and is detected only by auscultation (listening) of the myocardium and ECG.

The only option in which one can suspect the presence of a blockade before electrocardiography is the usual auscultation of the heart, or listening to it with a phonendoscope. The doctor may suspect this by ear if there is a splitting of tones that is not felt by the patient.

The next stage is to conduct a normal, routine ECG, during which the special shape of the ventricular complexes in the first chest leads is determined, as well as a slight increase in the duration of the gastric QRS complex to 0.11 seconds.

It is clear that this increase in time occurs due to the “circular path”, but the indirect following of the impulse along the blocked bundle branch.

Holter monitoring is also indicated, in which it is possible to identify functional or transient variants of the development of the blockade. This can happen, for example, due to an overdose of certain medications during treatment of diseases.

If the blockade of the leg occurs against the background of a cardiac disease, then an intracardiac electrophysiological study is performed. Its main task is to determine whether there are indications for placement (implantation) of a permanent pacemaker.

Additionally, in order to identify diseases that may cause cardiac conduction disturbances, the doctor may prescribe other examination methods:

general clinical blood and urine tests;
blood chemistry;
daily Holter monitoring of the electrocardiogram of the heart is prescribed in order to identify transient disturbances;
transesophageal electrocardiography is very precise method research, and therefore can be prescribed as an additional diagnostic method;
echocardiography is one of the most popular methods for studying the heart muscle; it shows organic cardiac pathology, the degree of myocardial contractility, and gives an accurate assessment of the cardiac ejection fraction;
if the diagnosis is unclear, it is possible to prescribe a multispiral computed tomography(CT) or, if appropriate equipment is available, magnetic resonance imaging (MRI) of the heart.

Cardiogram changes

By decoding the ECG performed, you can detect changes in the QRS complex, which are expressed in jaggedness and widening of its final part. An increase in the duration of the complex is also noted. The R wave in the chest lead is jagged and enlarged, and the ST segment in this part is lowered.

ECG signs of incomplete right bundle branch block:

The presence in the right precordial lead VI of a QRS complex of type rSr’ or rsR’, the presence of a slightly widened S wave in leads I and V6.
A slight increase in the duration of the QRS complex (up to 0.09 - 0.11 sec).

With this disorder, there is a slowdown in the conduction of the excitation impulse along the right bundle branch. Incomplete blockade of PNPG on the ECG is often diagnosed in absolutely healthy people young age. In such cases, changes are considered as a physiological norm.

In most cases, the disease is detected accidentally during a physical examination, listening to the heart (auscultation) and electrocardiography. Incomplete right bundle branch block is rarely accompanied by clinical manifestations.

Only in isolated cases when it decreases cardiac output, the following symptoms may occur:

regular dizziness;
frequent attacks of bradycardia;
pre-fainting and fainting states.

Therapeutic measures for incomplete blockade consist in treating the disease that is the cause of the blockade. That is, no specific therapy It is the blockade itself that needs to treat the underlying disease.

For example, birth defects in modern conditions, it can be operated on in a cardiac surgery clinic (if there are appropriate indications for this). If the patient suffers from heart failure, angina pectoris, hypertension, therapy is carried out with cardiac glycosides, antiarrhythmics, and antihypertensive drugs.

In some young people, this type of blockade is normal, so therapy is not prescribed. We can only recommend dynamic observation and examination by a cardiologist.

Depending on the identified underlying disease, the patient needs observation and treatment from a cardiologist or therapist. Observation involves assessing the dynamics of changes in the ECG and adjusting prescribed therapy based on clinical and laboratory examination.

Due to asymptomatic and a relatively favorable course, incomplete blockade of the right bundle branch does not require special treatment. The main efforts should be aimed at combating the causative disease, which in most cases is cardiac pathology.

The main drugs used in the treatment of diseases of the cardiovascular system are:

Calcium antagonists.
Antiplatelet agents.
Antiarrhythmics.
Anticoagulants.
Beta blockers.
Diuretics (diuretics).
ACE inhibitors.
Cardiac glycosides (digoxin), and others.

Comprehensive and rational use These drugs can neutralize the symptoms of the underlying disease, improve myocardial function, and also increase the patient’s survival and quality of life.

If incomplete blockade of the right bundle branch is first detected in a patient who complains of chest pain, shortness of breath, and who has a decrease in blood pressure, then he is urgently taken to the cardiac intensive care unit to exclude acute myocardial infarction.

If there is a threat of transformation of the right bundle branch block into complete atrioventricular block, as well as in the presence of recurrent fainting conditions, the patient is indicated for implantation of cardiac pacing. A cardiologist treats heart diseases. The patient’s life and health depend on the choice of specialist.

If the patient does not have serious abnormalities, we can recommend folk remedies, which normalize heart rate and conduction of nerve impulses. These home remedies have been tested for generations and proven to be effective.

Ramson (bear onion). Wild garlic bulbs contain ascorbic acid(natural analogue of aspirin), allicin, healing mineral salts And essential oils, as well as sugars that normalize the activity of the heart muscle.

As an auxiliary and preventive remedy, herbalists recommend taking an infusion of wild garlic. Recipe: combine a teaspoon of chopped wild garlic bulbs with 300 ml cold water.

Leave for one hour, then strain and refrigerate. Take 30 ml of the resulting drink three times a day. Attention! Treatment with wild garlic is contraindicated for gastritis and stomach ulcers!

Jaundice spreading. Spreading jaundice is another plant unique to the heart.

It contains cardiac glycosides - erizimoside and erizimin, as well as organic acids and fatty oils.

The main indication for the use of jaundice is mitral valve defects (and it is precisely this disease that is often associated with blockade of the right and left bundle branches).

In general, the plant normalizes blood circulation, increases the conductivity of electrical impulses, protects against heart attack and stroke, and improves the patient’s overall well-being. You can use a water or alcohol tincture of common jaundice.

To prepare a water tincture, you will need a teaspoon of herbs per 200 ml of boiling water. Dosage – a teaspoon three times a day (pi atrial fibrillation the dosage can be increased to 1 tablespoon 3 times a day).

To prepare an alcohol tincture, you will need 20g of spreading jaundice herb and 100 ml of alcohol. The mixture is infused in a dark place for 2 weeks, after which it must be filtered.

Dosage – 10 drops 3 times a day before meals (you can wash the drops down with water). Continue treatment for 6-10 months to obtain a stable, long-term effect.

Common hazel. Hazel will calm you down nervous system, will enhance the effectiveness of treatment of heart diseases and prevent serious pathologies in the ventricles.

We recommend making tea from this plant. To do this, you will need a tablespoon of hazel bark or leaves (dry crushed) and a glass of boiling water. Leave the mixture for 20 minutes, then take 100 ml twice a day.

Sedum is caustic. IN folk medicine Treatment with preparations from the herb sedum is popular.

This plant contains alkaloids, mineral salts, tannins and organic acids, which tone the body in general, and the heart in particular.

For bundle branch block, this is exactly what we need. Recipe: chop the dry plant, brew a teaspoon of sedum in a glass of boiling water. This is your daily dose. Drink it in a day. Therapy should last from 3 months to a year.

Dry grass is another highly effective herbal raw material for preparing a potion for problems with the His bundle.

All people suffering from heart disease (especially older people) can undergo periodic treatment with this herb.

It contains vitamin B1, phytosterols, ascorbic acid, and the alkaloid gnafalin, due to which it has a vasodilating effect, normalizes the balance of nerve impulses and the tone of the smooth muscles of the heart muscle.

Recipe: Brew a teaspoon of dry herb cudweed in a glass of boiling water and leave for half an hour. Take 3-4 tablespoons of infusion 4 times a day 20 minutes before meals. People with heart problems are also recommended to take wine made from cucumber.

To do this, pour a handful of dry herbs with a liter of high-quality red wine, leave for 2 weeks, then strain and add 100 ml of liquid linden honey. Drink 50 ml of the resulting wine every evening before bed.

Herbal mixtures are more effective because they simultaneously act “on all fronts”: they restore normal work bundle branches, reduce heart failure, prevent complications. So, in Rus', herbalists most often recommended the following herbal mixture:

Raspberry fruits – 20g;
Birch leaves – 10g;
Leonurus cordial herb – 10g;
Herb or dill seeds – 10g;
Periwinkle leaves – 20g.

Brew a tablespoon of this mixture with 0.5 liters of boiling water in a thermos, close the lid and leave for at least an hour. Every time 15 minutes before meals, drink half a glass of this drink. The course of treatment is from one month to a year (depending on the patient’s condition).

In an ancient French herbal medicine reference book we found the following recipe:

Combine all ingredients. Take a liter of water for 2 tablespoons of the mixture, bring the mixture to a boil, and immediately remove from the heat. Let the drug brew for half an hour, then strain it and drink a glass 4 times a day. In severe cases of heart failure, the dosage is halved.

Beautiful therapeutic effect gives the following fee:

Blood red hawthorn flowers – 30g;
Small periwinkle leaves – 30g;
Melissa leaves – 10g;
Spring adonis herb – 10g;
branches of lavender spikelet – 10g.

Take a heaping tablespoon of this mixture, pour a glass of cold water and leave for half an hour. Then put the medicine on the fire, boil for 5 minutes and cool. Drink the resulting medicine in small portions throughout the day. The course of treatment must last at least 2 months for you to feel a stable effect.

Incomplete blockade of the right bundle branch in itself does not pose a significant danger to the life and health of the patient. In the vast majority of cases, the pathology is not accompanied by any symptoms and is detected incidentally during a routine electrocardiographic study.

In this regard, incomplete RBBB does not require specific treatment. However, taking into account the fact that incomplete blockade of the right bundle branch often develops against the background of existing heart disease, it is natural to expect that it will have some effect on the course of the underlying pathology.

Indeed, studies confirm that RBBB worsens the course of cardiac diseases and increases the risk of cardiovascular complications and mortality in the coming years after its development.

It is important to note the unstable nature of the incomplete blockade of the right bundle branch. If the underlying heart disease worsens, this type of intraventricular conduction disorder can transform into complete RBBB, or even complete atrioventricular block, which will require a significant change in therapeutic tactics.

How dangerous is incomplete right bundle branch block? The prognosis for this condition is not determined by this formulation of the diagnosis. As mentioned above, the degree of development of the underlying disease is decisive, as well as the presence of the risk of developing complete atrioventricular block (in which the atria and ventricles can each contract in their own rhythm, disorganized).

It is the latter fact that can lead to the development ventricular arrhythmias. It should be noted that the blockade, especially incomplete, does not automatically mean the presence of arrhythmia. It’s just that, in the presence of predisposing and unfavorable factors, this can happen, and then the blockade of the leg, albeit incomplete, can increase the risk of sudden cardiac death.

Thus, the probability of a complete atrioventricular block in individuals with partial conduction disorders of the bundle branches is 1% per year.

Of course, this figure takes into account conditions in which there is severe cardiac pathology. It is in the presence of AV block that treatment will be required, which may include installing a pacemaker.

With this pathology, sinus arrhythmia is often observed, which is expressed by a violation of the heart rhythm; the rhythm of contractions is not performed at equal intervals.

The transesophageal electrocardiogram method is best suited for diagnosis. Patients sometimes experience:

weakness;
feeling of “fading” of the heart;
frequent tremors.

To get rid of sinus arrhythmia, you need to contact a cardiologist who will select the best treatment. Basic preventive measures:

For heart disease, a diet with foods rich in potassium, calcium and magnesium is important.
To prevent heart disease, it is important to avoid stress and anxiety.
Give up harmful addictions.
Play sports (as recommended by your doctor).

In case of incomplete blockade of the right bundle branch, sports are not contraindicated. After all, cardiologists are concerned about those conditions that increase the risk of sudden cardiac death, as well as various undiagnosed valve defects, especially aortic stenosis, which, when the load on the heart increases, can lead to unpredictable complications.

Isolated and asymptomatic conduction disorders, especially at a young age, do not lead to a significant increase in complications. IN as a last resort, you can perform Holter monitoring, which will be carried out against the background of sports training.

If the analysis of the results does not reveal progression of the volume of blockade, the appearance of arrhythmia, or signs of disorder of the atrioventricular connection, then there are no contraindications to sports activities. All that remains is to undergo an ECG annually in order to know in a timely manner the state of affairs with intraventricular conduction.

As for service in the armed forces, then, as we remember, in the absence of a clear interpretation, the entire emphasis is on “impairment of function.” In this case, given the absence of pronounced organic damage and the asymptomatic course, such a young man will be drafted into the army in category B-4, that is, “fit with minor restrictions.”

This actually means that he is unsuitable for the elite units of the RF Armed Forces, that is, where it is more or less prestigious to serve. As a result, he will be sent somewhere to the infantry, or to the signal troops, where, naturally, no restrictions will be observed, since the “automatic” determination of the type of troops will already serve as a guarantee that such restrictions have already been made.

If incomplete blockade is normal, no special treatment is needed. Periodic monitoring by a cardiologist and a heart check using an electrocardiogram are sufficient. And you need to take care to prevent complications:

Give up all bad habits.
Try to avoid any overload.
It's good to get enough sleep and relax after a working day.

Eat right, use natural fresh vegetables and fruits rich in potassium:

grape;
bananas;
fresh juices from them.

Do not ignore cases if they appear:

chest pain;
heaviness;
weakness;
dizziness.

It is appropriate to urgently contact a cardiologist and do an ECG, ultrasound of the heart, whatever the doctor prescribes. During blockades good means treatment and prevention are lily of the valley flowers and hawthorn fruits, which can only be consumed after consulting a doctor.