Different ECG manifestations of left ventricular hypertrophy in presence of intermittent LBBB and RBBB.

An 86-year-old female with aortic stenosis was qualified for invasive correction of the valvular heart disease. She developed a severe ventricular hypertrophy (LVH) and had an intermittent left bundle branch block (LBBB) and right bundle branch block (RBBB). We report the case of a single electrocardiographic examination showing changes specific for LVH, present in all forms of intraventricular conduction. The case perfectly depicts how the intracardiac vectors of depolarization change due to bundle branch blocks and how it effects QRS complex morphology.