MI Diagnosis in LBBB or paced rhythm: Difference between revisions
Jump to navigation
Jump to search
MI Diagnosis in LBBB or paced rhythm (view source)
Revision as of 08:29, 6 January 2009
, 6 January 2009no edit summary
m (→Examples) |
No edit summary |
||
Line 1: | Line 1: | ||
In case of a [[Intraventricular Conduction|left | In case of a [[Intraventricular Conduction|left bundle branch block (LBBB)]], infarct diagnosis based on the ECG is difficult. The baseline ST segments and T waves tend to be shifted in a discordant direction with LBBB, which can mask or mimic acute myocardial infarction. However, serial ECGs may show a moving ST segment during ischemia secondary to dynamic supply versus demand characteristics. A new LBBB is always pathological 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 elevation > 1mm in leads with a positive QRS complex (concordance in ST deviation) (score 5) | *ST elevation > 1mm in leads with a positive QRS complex (concordance in ST deviation) (score 5) | ||
*ST depression > 1 mm in V1-V3 (concordance in ST deviation) (score 3) | *ST depression > 1 mm in V1-V3 (concordance in ST deviation) (score 3) |