Electrocardiographic diagnosis of acute myocardial infarction in the presence of left bundle-branch block: can we "treat all" patients?
نویسنده
چکیده
The electrocardiographic features associated with acute myocardial infarction (AMI) are often easily recognised. However, interpretation is made more difficult in the presence of confounding patterns such as a left bundle branch block (LBBB). This may result in missed cases which may otherwise have benefited from acute revascularisation therapy. Though not straightforward, the diagnosis of AMI in the presence of LBBB can be made with a reasonable amount of accuracy. We report a case of acute myocardial infarction with LBBB that was appropriately diagnosed and underwent acute revascularisation by angioplasty. A detailed knowledge of the typical electrocardiographic features associated with LBBB, especially the ST segment morphologies, is very important. This will greatly aid recognition of an evolving AMI and help us decide on the most appropriate therapy.
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It is a common Knowledge that the ECG diagnosis of myocardial infarction in the presence of left bundle branch block (LBBB) is extremely difficult and often impossible. Physicians frequenlly recommend that patients with chest pain in the presence of LBBB receive thrombolytic therapy or urgent coronary arteriography assuming that acute injury and ischemia cannot be interpreted in the presence o...
متن کاملAcute myocardial infarction in the presence of left bundle branch block.
Background. The presence of left bundlebranch block on the electrocardiogram may conceal the changes of acute myocardial infarction, which can delay both its recognition and treatment. We tested electrocardiographic criteria for the diagnosis of acute infarction in the presence of left bundle-branch block. Methods. The base-line electrocardiograms of patients enrolled in the GUSTO-1 (Global Uti...
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INTRODUCTION Acute myocardial infarction is characterized by typical chest pain, electrocardiographic changes in terms of lesion and/or myocardial ischemia and increased cardiac enzymes. It is often difficult to make diagnosis in the presence of non-specific chest pain, the short duration of symptoms and electrocardiographic signs of a complete left bundle branch block. LITERATURE REVIEW Many...
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The population of patients with a pacemaker is constantly growing in number. Myocardial infarction in these patients, like in patients with left bundle branch block (LBBB), is called the undetermined type and characterizes the highest risk of death. Therefore the early and correct diagnosis of AMI is very important. The electrocardiographic criteria of the recognition of acute myocardial infarc...
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The occurrence of left bundle branch block (LBBB) is quite common in clinical practice. The changes in cardiac repolarization, caused by this disorder of electric conduction, may mask the presence of an acute myocardial infarction (AMI), delaying the diagnostic-therapeutic iter, with an important impact on prognosis. We describe the case of a woman of 59 years with LBBB, came to our observation...
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ورودعنوان ژورنال:
- The New England journal of medicine
دوره 335 2 شماره
صفحات -
تاریخ انتشار 1957