Coronary arteriographic appearances in patients with left anterior hemiblock.

24 of 163 consecutive patients (14.7%) undergoing selective coronary arteriography were found to have electrocardiographic evidence of left anterior hemiblock. 3 patients (2 of whom had alcoholic cardiomyopathy) had normal coronary arteries, 15 patients had triple vessel disease, 3 patients had double vessel disease, and 3 patients had single vessel disease. 18 patients (75%) had moderate to severe left ventricular enlargement as estimated by left ventriculogram. Comparison of these angiographic findings with those of 88 patients with normal intraventricular conduction showed the distribution of the coronary artery disease to be essentially similar in the two groups but that significant left ventricular enlargement was at least three times more frequent in patients with left anterior hemiblock than in patients with normal intraventricular conduction. It is suggested that the development of left anterior hemiblock depends more upon the presence of left ventricular enlargement than on the distribution of the coronary artery disease.