Left Bundle Branch Block Chest Pain Conundrum
Left bundle branch block is a pattern of altered ventricular depolarization and subsequently affects repolarization. These obscure patterns can affect the traditional ST segment shift criteria for the electrocardiographic detection of coronary insufficiency syndromes. Previously, patients with coron...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Case Reports in Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2020/2724981 |
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| _version_ | 1832553950013816832 |
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| author | Karthik Seetharam Ayesha Cheema Gary Friedman Roman Pachulski |
| author_facet | Karthik Seetharam Ayesha Cheema Gary Friedman Roman Pachulski |
| author_sort | Karthik Seetharam |
| collection | DOAJ |
| description | Left bundle branch block is a pattern of altered ventricular depolarization and subsequently affects repolarization. These obscure patterns can affect the traditional ST segment shift criteria for the electrocardiographic detection of coronary insufficiency syndromes. Previously, patients with coronary ischemic pain and LBBB judged to be “new” (not previously documented) were considered to have ST elevation myocardial infarction (STEMI) warranting acute thrombolytic therapy. Current STEMI management favors emergent invasive angiography; however, recent data suggests the prevalence of coronary obstructive pathology may be as low as 50%. The application of more specific, less-sensitive Sgarbossa electrocardiographic criteria may reduce angiographic assessment in an otherwise high-risk population unlikely to tolerate further myocardial injury. We present a case that may facilitate a more nuanced EKG-based approach to distinguish those who may benefit from acute invasive angiography while reducing the frequency of unnecessary angiographic evaluation. |
| format | Article |
| id | doaj-art-786c2d5343cd43b8837aea044fdb7b3c |
| institution | Kabale University |
| issn | 2090-6404 2090-6412 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Cardiology |
| spelling | doaj-art-786c2d5343cd43b8837aea044fdb7b3c2025-02-03T05:52:44ZengWileyCase Reports in Cardiology2090-64042090-64122020-01-01202010.1155/2020/27249812724981Left Bundle Branch Block Chest Pain ConundrumKarthik Seetharam0Ayesha Cheema1Gary Friedman2Roman Pachulski3Division of Cardiology, St. John’s Episcopal Hospital-South Shore, New York, New York, USADivision of Cardiology, St. John’s Episcopal Hospital-South Shore, New York, New York, USADivision of Cardiology, St. John’s Episcopal Hospital-South Shore, New York, New York, USADivision of Cardiology, St. John’s Episcopal Hospital-South Shore, New York, New York, USALeft bundle branch block is a pattern of altered ventricular depolarization and subsequently affects repolarization. These obscure patterns can affect the traditional ST segment shift criteria for the electrocardiographic detection of coronary insufficiency syndromes. Previously, patients with coronary ischemic pain and LBBB judged to be “new” (not previously documented) were considered to have ST elevation myocardial infarction (STEMI) warranting acute thrombolytic therapy. Current STEMI management favors emergent invasive angiography; however, recent data suggests the prevalence of coronary obstructive pathology may be as low as 50%. The application of more specific, less-sensitive Sgarbossa electrocardiographic criteria may reduce angiographic assessment in an otherwise high-risk population unlikely to tolerate further myocardial injury. We present a case that may facilitate a more nuanced EKG-based approach to distinguish those who may benefit from acute invasive angiography while reducing the frequency of unnecessary angiographic evaluation.http://dx.doi.org/10.1155/2020/2724981 |
| spellingShingle | Karthik Seetharam Ayesha Cheema Gary Friedman Roman Pachulski Left Bundle Branch Block Chest Pain Conundrum Case Reports in Cardiology |
| title | Left Bundle Branch Block Chest Pain Conundrum |
| title_full | Left Bundle Branch Block Chest Pain Conundrum |
| title_fullStr | Left Bundle Branch Block Chest Pain Conundrum |
| title_full_unstemmed | Left Bundle Branch Block Chest Pain Conundrum |
| title_short | Left Bundle Branch Block Chest Pain Conundrum |
| title_sort | left bundle branch block chest pain conundrum |
| url | http://dx.doi.org/10.1155/2020/2724981 |
| work_keys_str_mv | AT karthikseetharam leftbundlebranchblockchestpainconundrum AT ayeshacheema leftbundlebranchblockchestpainconundrum AT garyfriedman leftbundlebranchblockchestpainconundrum AT romanpachulski leftbundlebranchblockchestpainconundrum |