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58 year old female CC: Chest pain - Conclusion

Posted Jul 29 2010 7:31am
Here's the conclusion to the 58 year old female with chest pain and left bundle branch block .

To refresh your memory here is the 12-lead ECG.


And for those of you who requested lead V4R.



This ECG meets all 3 of Sgarbossa's criteria to identify acute STEMI in the presence of left bundle branch block.

Keep in mind, it only has to meet one criterion in one lead!

(Please note: One criterion has been modified from its original form. Instead of discordant ST-elevation > 5 mm we are looking for discordant ST-elevation > 0.2 the depth of the S-wave. Credit to Dr. Smith of Dr. Smith's ECG Blog.)




Angiography revealed 100% occlusion of the LCX and 99% occlusion of the RCA.

Thanks to everyone who commented on the case!

See also
AMI in the presence of LBBB - Sgarbossa's Criteria Part I




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