Beyond the Veil of Pacing: A Sgarbossa STEMI
Meghan Stevenson1, Naveed Younis1
1St. Bernards Internal Medicine Residency Program, Jonesboro, Arkansas, USA; St. Bernards Medical Center, Jonesboro, Arkansas, USA.
Insights
The Sgarbossa criteria are crucial for diagnosing ST-segment elevation myocardial infarction in paced patients. Overlooking these criteria can lead to delayed treatment and severe outcomes like cardiogenic shock.
Area of Science:
- Cardiology
- Emergency Medicine
Background:
- The Sgarbossa criteria aid in diagnosing ST-segment elevation myocardial infarction (STEMI).
- These criteria are specifically designed for patients with ventricular pacing or left bundle branch block (LBBB).
Background:
The Sgarbossa criteria were designed to diagnose ST-segment elevation myocardial infarction in patients who are ventricularly paced or have left bundle branch block.
Case Summary:
We report the case of a 74-year-old man who presented with chest pain. The patient had an acute myocardial infarction per the Sgarbossa criteria, but diagnosis was delayed because of the presence of ventricular pacing. Because of this error, intervention was delayed, and the patient eventually developed cardiogenic shock.
Discussion:
Even though the Sgarbossa criteria are well established, they are often overlooked, which may result in significant morbidity or mortality. This case emphasizes the importance of using the Sgarbossa criteria to evaluate patients in appropriate populations.
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