{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:33:40Z","timestamp":1787762020154,"version":"build-2784847793"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Masquerading bundle branch block (MBBB) is a rare presentation of bifascicular blocks. It is the result of a right bundle branch block associated with an advanced left anterior fascicular block due to extensive damage to the conduction system. We present the case of a 75-year-old male with late onset presentation anterior wall myocardial infarction (MI) with ongoing ischemia (which evolved into a ventricular septal defect [VSD]). Electrocardiographically, the MBBB is characterized by a prominent R in V1, left axis deviation and absence of small S waves in I and aVL. Its presence confers a poor prognosis and high risk of progressing to advanced atrioventricular block (AAVB). A mortality rate between 18% and 38.9% has been found and 41.4%\u201359% of the patients develop AAVB requiring pacemaker implantation. To our knowledge, this is the first reported MBBB case in the setting of an MI complicated with VSD, demonstrating its association with the presence of critical anteroseptal ischemia. The patient rejected any kind of intervention, palliative care was offered, and he died 2 months later.<\/jats:p>","DOI":"10.4103\/tjem.tjem_64_24","type":"journal-article","created":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T14:00:15Z","timestamp":1735826415000},"page":"59-62","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Masquerading details behind a murmur and chest pain"],"prefix":"10.4103","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0185-509X","authenticated-orcid":false,"given":"Alejandro Narvaez","family":"Orozco","sequence":"first","affiliation":[{"name":"University of Antioquia, Hospital Universitario San Vicente Fundacion, Medellin, Colombia"},{"name":"Division of Internal Medicine and Cardiology, Hospital Universitario San Vicente Fundacion, Medellin, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7428-1859","authenticated-orcid":false,"given":"Alberto Navarro","family":"Navajas","sequence":"additional","affiliation":[{"name":"University of Antioquia, Hospital Universitario San Vicente Fundacion, Medellin, Colombia"},{"name":"Division of Internal Medicine and Cardiology, Hospital Universitario San Vicente Fundacion, Medellin, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8267-2534","authenticated-orcid":false,"given":"Alejandra Ramirez","family":"Roldan","sequence":"additional","affiliation":[{"name":"University of Antioquia, Hospital Universitario San Vicente Fundacion, Medellin, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5471-1322","authenticated-orcid":false,"given":"Camilo Lopez","family":"Ocampo","sequence":"additional","affiliation":[{"name":"University of Antioquia, Hospital Universitario San Vicente Fundacion, Medellin, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8312-7194","authenticated-orcid":false,"given":"Juan Manuel Senior","family":"Sanchez","sequence":"additional","affiliation":[{"name":"University of Antioquia, Hospital Universitario San Vicente Fundacion, Medellin, Colombia"},{"name":"Division of Internal Medicine and Cardiology, Hospital Universitario San Vicente Fundacion, Medellin, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,1,2]]},"reference":[{"key":"R1-20250106","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1161\/01.CIR.101.1.27","article-title":"Risk factors, angiographic patterns, and outcomes in patients with ventricular septal defect complicating acute myocardial infarction. GUSTO-I (Global Utilization of Streptokinase and TPA for Occluded Coronary Arteries) trial \u0131nvestigators","volume":"101","author":"Crenshaw","year":"2000","journal-title":"Circulation"},{"key":"R2-20250106","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1111\/joic.12556","article-title":"Management of post-myocardial infarction ventricular septal defects: A critical assessment","volume":"31","author":"Omar","year":"2018","journal-title":"J Interv Cardiol"},{"key":"R3-20250106","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1016\/S0735-1097(00)00878-0","article-title":"Outcome and profile of ventricular septal rupture with cardiogenic shock after myocardial infarction: A report from the SHOCK trial registry. SHould we emergently revascularize occluded coronaries in cardiogenic shocK?","volume":"36","author":"Menon","year":"2000","journal-title":"J Am Coll Cardiol"},{"key":"R4-20250106","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1001\/jamainternmed.2022.4708","article-title":"Right bundle-branch block pattern in precordial leads and left bundle-branch block pattern with left axis deviation in frontal plane leads-what does this mean?","volume":"182","author":"Scheffer","year":"2022","journal-title":"JAMA Intern Med"},{"key":"R5-20250106","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/0002-8703(54)90295-1","article-title":"Left bundle branch block masquerading as right bundle branch block","volume":"47","author":"R\u0131chman","year":"1954","journal-title":"Am Heart J"},{"key":"R6-20250106","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1161\/01.CIR.17.3.397","article-title":"The concept of masquerading bundle-branch block;an electrocardiographic-pathologic correlation","volume":"17","author":"Unger","year":"1958","journal-title":"Circulation"},{"key":"R7-20250106","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1586\/erc.12.142","article-title":"Masquerading bundle branch block: A variety of right bundle branch block with left anterior fascicular block","volume":"11","author":"Elizari","year":"2013","journal-title":"Expert Rev Cardiovasc Ther"},{"issue":"(Suppl_3)","key":"R9-20250106","first-page":"14845","article-title":"Abstract 14845: Masquerading bundle branch block: An electrocardiographic marker of poor prognosis","volume":"132","author":"Schroder e Souza","year":"2015","journal-title":"Circulation"},{"key":"R10-20250106","doi-asserted-by":"crossref","first-page":"1517","DOI":"10.1111\/j.1540-8159.1988.tb06267.x","article-title":"Study of the evolution of masked bifascicular block","volume":"11","author":"Bay\u00e9s de Luna","year":"1988","journal-title":"Pacing Clin Electrophysiol"},{"key":"R11-20250106","doi-asserted-by":"crossref","first-page":"e57","DOI":"10.1016\/j.jccase.2013.04.005","article-title":"Masquerading bundle branch block as a marker of poor prognosis","volume":"8","author":"Kaimoto","year":"2013","journal-title":"J Cardiol Cases"},{"key":"R12-20250106","first-page":"92","article-title":"Clinical and electrocardiographic features of disguised bifascicular block","volume":"50","author":"Gomez Barrado","year":"1997","journal-title":"Rev Esp Cardiol"}],"container-title":["Turkish Journal of Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/tjem.tjem_64_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:11:12Z","timestamp":1787760672000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/tjem.tjem_64_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/tjem.tjem_64_24","relation":{},"ISSN":["2452-2473","2452-2473"],"issn-type":[{"value":"2452-2473","type":"print"},{"value":"2452-2473","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2024-03-31","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-12","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}