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Chapter 2: Cardiac failure 61

I aVR V1 V4

II aVL V2 V5

III aVF V3 V6

Rhythm strip
(II)

Figure 2.14 Partial right bundle branch block.

Management ing in a failure to maintain sufficient cardiac output to
Treatment is not necessary. meet the demands of the body. The clinical syndrome of
heart failure is characterised by breathlessness, fatigue
and fluid retention.
Prognosis
Isolated right bundle branch block, particularly in a
young person is generally benign. Concomitant left or Prevalence/incidence
severe right axis deviation may indicate block in one of 900,000 cases in the United Kingdom; 1–4 cases per 1000
the fascicles of the left bundle, which can occur as a pre- population per annum.
cursor to complete heart block which in turn carries a
worse prognosis.
Age
Average age at diagnosis 76 years.
Cardiac failure
Aetiology
The most common cause of heart failure in the United
Heart failure
Kingdom is coronary artery disease (65%). Causes in-
Definition clude
Heart failure is a complex syndrome that can result from myocardial dysfunction, e.g. ischaemic or hyperten-
any cardiac disorder (structural or functional) result- sive heart disease, cardiomyopathy.