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Dr. Roach: Heart finds a way around bundle branch block

Keith Roach
To Your Health

Dear Dr. Roach: I’m a female, age 70, who is 5 feet, 4 inches tall and weighs 125 pounds. I have no problems with cholesterol, diabetes or blood pressure. I do not take any medications, just vitamins. I take dance exercise classes and walk often. I recently went for my checkup and found that I have a left bundle branch block. What happened? How did I get this? Is there anything I can do?

Do I continue taking exercise classes, or will it make my heart worse? Not sure if this has anything to do with it, but at about the age of 6, I was told I had scarlatina. I had to take penicillin for a year and had a heart murmur. The murmur went away in my 40s. Please write about this in your newspaper column.

Anon.

Dear Anon: The bundle branches carry electrical impulses inside the heart, and in the ventricle, there are two main branches — the left bundle branch and the right. A left bundle branch block is the blockage of one of the main “wires” to the heart. Fortunately, the impulse still can be carried across the muscle cells, so usually there are no symptoms, and you need not make changes to your busy lifestyle. Your doctor will have done a careful checkup on you, since other heart issues, including blockages in the arteries and a weakened heart muscle, sometimes are associated with LBBB.

Scarlet fever (I like the delightfully old-fashioned term “scarlatina”) is a complication of strep throat and is occasionally confused with rheumatic fever, another complication. Scarlet fever causes a characteristic rash with a sandpaper quality, whereas rheumatic fever can cause permanent damage to heart valves. Scarlet fever does not affect the heart, and rheumatic fever usually does not affect the bundle branches.

Most people with bundle branch block have an excellent prognosis; however, if there is further damage to your conduction system, you likely will need a permanent pacemaker. I would not stop your exercise classes, as these provide many benefits to your heart (as well as the rest of you).

Dear Dr. Roach: Going through menopause was a breeze. In those years, I used a lot of soy sauce in my wok cooking. I gave up the wok in my early 50s. My libido has decreased over the ensuing years. I am now 65 and am again using soy sauce. My libido has increased. Is there some connection between soy sauce and a woman’s hormones?

M.S.

Dear M.S.: Soy protein contains isoflavones, which can act like estrogens in some circumstances. I have been asked frequently whether soy protein is safe for women with a history of estrogen-receptor-positive breast cancer, and the answer is that it probably is, at least in reasonable amounts, but checking with your own oncologist is always a good idea.

Soy sauce, on the other hand, has no protein and no isoflavones, and shouldn’t affect your hormone levels. I can’t explain why your libido has increased with the soy sauce, except to say that libido is complicated and potentially affected by many factors, both in body

Email questions to ToYourGoodHealth@med.cornell.edu.