Right Branch Block: Symptoms, Causes, Risk Factors, Complications, Diagnosis and Treatment

It is a condition in which there is a delay or obstruction along the route that the electrical impulses travel to make your heartbeat.

The delay or blockage can occur in the path that sends electrical impulses to your heart’s left or right side of the lower chambers (ventricles).

Blocking the branches sometimes makes it harder for your heart to pump blood efficiently through your circulatory system.

There is no specific treatment for the right bundle branch block itself. However, any underlying health condition that has caused a branch block, such as heart disease, should be treated.


In most people, the branch block does not cause any symptoms. Sometimes people with the condition do not even know they have a branch block.

For those people who do have signs and symptoms, they may include:

  • Fainting ( syncope )
  • I was feeling as if you were fainting (presyncope).

When to See a Doctor

If you have fainted, consult your doctor to rule out any serious underlying cause.


If you have heart disease or your Doctor has already diagnosed you with the right bundle branch block, ask your Doctor how often you should make follow-up visits.

You may want to carry a medical alert card that identifies you as a branch block if you are seen in an emergency by a doctor unfamiliar with your medical history.


Usually, the electrical impulses inside the muscles of your heart make it beat (contract). These impulses travel along a path, including the right and left beams.

If one or both bundles of branches are damaged, due to a heart attack, for example, this change can block the electrical impulses and cause the heart to beat abnormally.

The underlying cause of the correct branch blockages may differ depending on whether the right or left branch is affected. It is also possible that this condition can occur without any known underlying cause. Specific causes may include:

Left Branch Block

  • Heart disease.
  • Thickened, rigid, or weakened heart muscle ( cardiomyopathy ).
  • A viral or bacterial infection of the heart muscle ( myocarditis ).
  • High blood pressure ( hypertension ).

Right Branch Block

  • A cardiac anomaly is present at the time of birth (congenital), such as a defect in the atrial septum or a hole in the wall that separates the heart’s upper chambers.
  • A heart attack (myocardial infarction).
  • A viral or bacterial infection of the heart muscle (myocarditis).
  • High blood pressure (hypertension).
  • A blood clot in the lungs ( pulmonary embolism ).

Risk factor’s

Risk factors for branch block include:

Increasing age: branch block is more common in older adults than in middle-aged people.

Underlying health problems: People with high blood pressure or heart disease are more likely to have branch blocks than those without those conditions.


The main complication of the branch block is the slow heart rate, which can sometimes cause fainting.

People with a heart attack who develop a branch block have more chances of complications, including sudden cardiac death than those with heart attacks which do not develop a branch block.

Because branch block affects the electrical activity of your heart, it can sometimes complicate the accurate diagnosis of other heart conditions, especially heart attacks. It may cause delays in the proper management of those problems.


Tests that can be used to diagnose a branch block or the underlying problem that causes it include:

Electrocardiogram:  An electrocardiogram records the electrical impulses in your heart through wires connected to the skin in your chest and other locations in your body. The anomalies can indicate the presence of a branch block and which side is affected.

Echocardiogram: An echocardiogram can be used to identify an underlying condition that caused the right bundle branch block. This test uses sound waves to produce images of the heart, allowing your doctor to see your heart moving.

An echocardiogram provides detailed images of the heart’s structure and shows the thickness of your heart muscle and if the valves in your heart move normally.


Most people with branch block have no symptoms and do not need treatment.

However, if you have an underlying heart condition that causes branch blockage, treatment of the underlying condition is recommended.

Treatment of underlying conditions may involve using medications to reduce high blood pressure or decrease the effects of heart failure or a coronary angioplasty to open the artery leading to the heart.

Also, depending on your symptoms and if you have other heart problems, your doctor may also recommend:

A pacemaker: Doctors may recommend implanting a pacemaker for some people with branch block and a history of fainting.

A pacemaker is a compact device implanted under the skin of your upper chest (internal pacemaker) with two wires that connect to the right side of your heart. The pacemaker provides electrical impulses when necessary to keep your heart beating regularly.

Cardiac resynchronization: also known as biventricular pacing, this procedure is similar to the implantation of a pacemaker. However, in cardiac resynchronization, a third cable is connected to the left side of the heart so that the device can keep both sides at the proper pace.

Preparing for your Medical Appointment

You are likely to start by seeing your primary care doctor first. However, you may be referred to a doctor specializing in cardiac disorders (cardiologist).

Below you will find information to help you prepare for your appointment and what to expect from your Doctor. What you can do:

  • Keep in mind any restrictions before the appointment; when you make the appointment, be sure to ask if there is anything you need to do in advance, such as restricting your caffeine intake before having cardiac function tests.
  • Write down any symptoms you are experiencing, including any that may seem unrelated to why you scheduled the appointment.
  • Write down critical personal information, including significant stresses or recent life changes.
  • Make a list of all the medications, vitamins, and supplements you take. Also, write down the dose you are taking.
  • Ask a family member or friend to accompany you, if possible. Sometimes it can be hard to remember all the information provided during an appointment. Someone who accompanies you can remember something you missed or forgot.
  • Write down doubts to consult with your Doctor.

Preparing a list of questions can help you make the most of your time with your Doctor. For the right bundle block, some basic questions to ask your doctor include:

  • What are the most likely causes of my symptoms?
  • What kind of tests do I need?
  • Do these tests require any special preparation?
  • What treatments are available, and which ones are recommended?
  • Will the branch block return after treatment?
  • What types of side effects can I expect from the treatment?
  • I have other health conditions. How can I better manage these conditions together?
  • Are there brochures or other printed material that I can take home?
  • What websites do you recommend visiting?

What to expect from your Doctor

Your Doctor will probably ask you a series of questions. Being prepared to answer them can set aside time to review any point you want to spend more time on. Your Doctor can ask:

  • When did you start experiencing symptoms for the first time?
  • Is there anything that improves your symptoms?
  • What, in any case, seems to make your symptoms worse?
  • Has a doctor ever told you that you have a branch block?

Right bundle branch block is not an uncommon finding in the general population. The prevalence increases with age; it is observed more frequently in older adults.

Blocking the correct branch is not uncommon in young people, especially athletes. The prevalence in young, middle-aged, and elderly individuals are believed to be 0.2%, 0.7%, and 11.3%, respectively.

What is the importance of the right bundle branch block in an electrical trace of the heart?

Blocking the right branch of the bundle of His is usually an incidental finding in an electrical trace of the heart, which would have been carried out for another reason. However, in the presence of symptoms such as chest pain or shortness of breath, or syncope, it could mean underlying cardiac or pulmonary disorders, such as:

  • Long-term right heart failure.
  • Myocardial infarction (heart attack).
  • Congenital heart conditions (hole in the heart).
  • Long permanent lung conditions that affect the right side of the heart.
  • Pulmonary embolism (clot in the lung).

The right bundle branch block observed in elderly individuals without cardiac problems could be due to the degenerative changes of the right bundle as part of the normal aging process.

Does the right bundle branch block need further investigation and treatment?

As mentioned earlier, the right bundle branch block may be an incidental finding. If there are no associated symptoms, there is no need for further investigation and treatment.

However, if it is associated with any of the symptoms mentioned above, an additional echocardiography (heart ultrasound) evaluation is required.

On the other hand, the left bundle branch block in the electrical tracing of the heart may suggest underlying cardiac conditions, which means more research will be done.