191
edits
Line 197: | Line 197: | ||
==Infarct diagnosis in LBBB== | ==Infarct diagnosis in LBBB== | ||
In case of a left bundelbranch block (LBBB), infarct diagnostics based on the ECG is difficult. The ST segments are always abnormal in a LBBB, so new ischemia can not be detected. A new LBBB is always pathologocal and can be a sign of myocardial infarction. The criteria (Sgarbossa <cite>LBTB</cite>) that can be used in case of a LBBB and suspicion of infarction are: | |||
*ST | *ST elevation > 1mm in leads with a positive QRS complex (concordance in ST deviation) (score 5) | ||
*ST | *ST depression > 1 mm in V1-V3 (discordance in ST deviation) (score 3) | ||
*ST | *ST elevation > 5 mm in leads with a negative QRS complex (discordance in ST deviation) (score 2) | ||
At a score-sum of 3, these criteria have a specificity of 90% for detecting a myocardial infarction. | |||
{{clr}} | {{clr}} | ||