Faculty Collaboration Database

Left bundle branch block pattern complicating the electrocardiographic evaluation of acute myocardial infarction. Acad Emerg Med 1997 Jan;4(1):56-62

Date

01/01/1997

Pubmed ID

9110013

DOI

10.1111/j.1553-2712.1997.tb03644.x

Scopus ID

2-s2.0-8044245451 (requires institutional sign-in at Scopus site)   21 Citations

Abstract

The ECG diagnosis of ischemic heart disease is made more difficult in the setting of left bundle branch block (LBBB). The ECG diagnosis of prior or remote myocardial infarction (MI) is extremely difficult in this setting. Furthermore, the associated--and expected--ST-segment--T-wave abnormalities of LBBB may mimic acute ischemic change. However, ECG detection of abnormalities arising from acute ischemic cardiac disease in the setting of LBBB can be valuable. Several strategies are available to the emergency physician (EP) to assist in the correct interpretation of this ECG pattern, including: a knowledge of the anticipated ST-segment--T-wave changes of LBBB and, consequently, the ability to recognize ischemic morphologies; the performance of serial ECGs demonstrating dynamic changes encountered in ischemic patients; and a comparison with previous ECGs. Three cases are reported in which an analysis of the 12-lead ECG in the setting of LBBB assisted the EP in establishing the correct diagnosis of acute MI and applying timely, appropriate therapy.

Author List

Brady WJ Jr, Aufderheide TP

Author

Tom P. Aufderheide MD Professor in the Emergency Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Bundle-Branch Block
Electrocardiography
Female
Humans
Male
Middle Aged
Myocardial Infarction