Open AccessManaging chest pain in patients with concomitant left bundle-branch block
Author(s) -
Andrew R. Wyant,
Somu Chatterjee,
Tamara Bennett
Publication year - 2017
Publication title -
journal of the american academy of physician assistants
Language(s) - English
Resource type - Journals
ISSN - 0893-7400
DOI - 10.1097/01.jaa.0000525904.44484.5c
Subject(s) - left bundle branch block , concomitant , medicine , chest pain , myocardial infarction , cardiology , bundle branch block , electrocardiography , heart failure
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.