instruction: hello doctor I would like to send you my daughter egg for evaluation this was taken at the er I think she had heartburn we are now concerned about the abnormal report
output: hi I have seen the egg of your daughter she has a condition called right bundle branch block a right bundle branch block rbb is a heart block in the electrical conduction system our heart is divided into four chambers upper two are called aria and the lower two are called ventricle every heartbeat starts from the sino atrial node in the right aria called pacemaker of the heart and is conducted to ventricles through bundle branches arising from bundle of his in the ventricle the right bundle branch supplies the right ventricle while the left bundle branch supplies the left bundle during a right bundle branch block the right ventricle is not directly activated by impulses traveling through the right bundle branch the left ventricle however is still normally activated by the left bundle branch though in 85 of adult population rbb is a normal finding yet as your daughter is in the pediatric age group it can be because of atrial septal defect also a detailed history is required before concluding if its atrial septal defect or not you have not mentioned her symptoms does she had breathlessness especially while playing does she have chest pain any history of recurrent chest infections in her childhood why was she taken to er does she have gastritis or acid peptic disorder or heartburn previously does she ever had heart palpitation is she over fatigued as compared to her friend in doing the same amount of work I need answers to the above questions before giving a further advice right bundle branch block atrial septal defect follow up with a detailed history