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--- abstract: | The electrocardiogram (ECG) criteria for the left septal fascicular block (LSFB) are not universally accepted and many other denominations can be seen in literature: focal septal block, septal focal block, left septal fascicular block, left anterior septal block, septal fascicular conduction disorder of the left branch, left septal Purkinje network block, left septal subdivision block of the left bundle branch, anterior conduction delay, left median hemiblock, left medial subdivision block of the left bundle branch, middle fascicle block, block of the anteromedial division of the left bundle branch of His, and anteromedial divisional block. During exercise stress test, fascicular blocks (left anterior and posterior) seem to indicate severe coronary artery narrowing of left main coronary or proximal left anterior descending artery disease1 and transient exercise-induced left septal fascicular block has been reported a few times2,3. 54-year-old male, with a history of essential arterial systemic hypertension, primary hyperlipidemia and six-month typical chest pain during exercise (Class II – Canadian Cardiovascular Society) underwent an exercise stress test. During the exercise stress test, ECG demonstrated abrupt prominent anterior forces, an increase in R wave amplitude from V1 to V4, extreme left axis deviation and minor ST segment depression in DII, DIII and aVF (Figure 1). The post-exercise period showed progressive return of the QRS axis in both frontal and horizontal planes and the ST depression worsened by 1 mm. Coronary angiogram (Figure 2A) showed a critical proximal left anterior descending artery lesion. An exercise stress test done three months after coronary artery bypass surgery grafting was normal (Figure 2B). altloc: - http://www.ipej.org/0602/uchida.htm chapter: ~ commentary: ~ commref: ~ confdates: ~ conference: ~ confloc: ~ contact_email: ~ creators_id: [] creators_name: - family: Uchida given: Augusto Hiroshi honourific: '' lineage: '' - family: Moffa given: Paulo Jorge honourific: '' lineage: '' - family: Riera given: Andrés Ricardo Pérez honourific: '' lineage: '' - family: Ferreira given: ' Beatriz Moreira Ayub' honourific: '' lineage: '' date: 2006-04 date_type: published datestamp: 2006-04-01 department: ~ dir: disk0/00/00/48/06 edit_lock_since: ~ edit_lock_until: ~ edit_lock_user: ~ editors_id: [] editors_name: - family: Singh given: Balbir honourific: '' lineage: '' - family: Lokhandwala given: Yash honourific: '' lineage: '' - family: Francis given: Johnson honourific: '' lineage: '' - family: Gupta given: Anup honourific: '' lineage: '' - family: Ghosh given: Joydeep honourific: '' lineage: '' eprint_status: archive eprintid: 4806 fileinfo: /style/images/fileicons/text_html.png;/4806/1/uchida.htm|/style/images/fileicons/application_pdf.png;/4806/2/uchida.pdf full_text_status: public importid: ~ institution: ~ isbn: ~ ispublished: pub issn: ~ item_issues_comment: [] item_issues_count: 0 item_issues_description: [] item_issues_id: [] item_issues_reported_by: [] item_issues_resolved_by: [] item_issues_status: [] item_issues_timestamp: [] item_issues_type: [] keywords: Exercise-induced left septal fascicular block; myocardial ischemia lastmod: 2011-03-11 08:56:22 latitude: ~ longitude: ~ metadata_visibility: show note: ~ number: 2 pagerange: 135-138 pubdom: TRUE publication: Indian Pacing and Electrophysiology Journal publisher: Indian Pacing and Electrophysiology Group refereed: TRUE referencetext: ~ relation_type: [] relation_uri: [] reportno: ~ rev_number: 14 series: ~ source: ~ status_changed: 2007-09-12 17:02:42 subjects: - ipej succeeds: ~ suggestions: ~ sword_depositor: ~ sword_slug: ~ thesistype: ~ title: 'Exercise-induced left septal fascicular block: an expression of severe myocardial ischemia' type: journalp userid: 4424 volume: 6