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Seventy-one-year-old man with transient left bundle branch block

A 71-year-old man attended the emergency department with an episode of transient loss of consciousness. He had collapsed while standing from a sitting position soon after a hot bath. There was no antecedent chest pain; however, following this episode, he reported new onset exertional dyspnoea while walking around his home. Electrocardiography on presentation demonstrated intermittent left bundle branch block (QRS duration 145 ms), and an echocardiogram confirmed a normal size left ventricle with normal left ventricular systolic …