Managing chest pain in patients with concomitant left bundle-branch block
Andrew Wyant1, Somu Chatterjee, Tamara Bennett
1Andrew Wyant, Somu Chatterjee, and Tamara Bennett are assistant professors in the PA program at the University of Kentucky in Lexington, Ky. The authors have disclosed no potential conflicts of interest, financial or otherwise.
Abstract:
Diagnosis and timely management of acute myocardial infarction (MI) relies heavily on the ST-segment elevation sum. Presence of concomitant left bundle-branch block (LBBB) in patients presenting with possible acute MI presents a diagnostic dilemma. The LBBB pattern distorts ST-segment changes, delaying or preventing accurate diagnosis. This article reviews the Sgarbossa criteria and ST/S ratio and presents a treatment algorithm that may help improve patient care and reduce morbidity and mortality.
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