Abstract
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 for a constrictive chest pain associated with dyspnea. The diagnostic workup for suspected acute coronary syndrome (ACS), initially conducted only on the analysis of the electrocardiogram (negative TnI at entry), showed the presence of coronary arteries free of stenosis. However, the diagnostic confirmation of AMI was completed after the rise of cardiac markers and the electrocardiographic changes. This case confirm the difficulty about the diagnosis of AMI in patients with LBBB and stresses, however, as the use of some criteria proposed in the literature [1-3] can guide to its identification, directing patient to an appropriate treatment.
Highlights
The occurrence of a right bundle branch block or a left one, is quite common in routine electrocardiograms (ECGs)
We describe the case of a woman of 59 years with left bundle branch block (LBBB), came to our observation for a constrictive chest pain associated with dyspnea
Several authors have focused their attention on the management of patients with suspected acute coronary syndrome (ACS) and LBBB on ECG [4,5,6], in order to identify electrocardiographic criteria which could allow the diagnosis of acute myocardial infarction (AMI) fastest, optimizing at the same time, the results of reperfusion therapy [7,8]
Summary
The occurrence of a right bundle branch block or a left one, is quite common in routine electrocardiograms (ECGs). The LBBB is often evident in patients with cardiac injury and/or systemic hypertension. The changes in cardiac repolarization in this disorder of electric conduction, may mask the classical electrocardiographic changes of -ST segment in patients with AMI. Several authors have focused their attention on the management of patients with suspected ACS and LBBB on ECG [4,5,6], in order to identify electrocardiographic criteria which could allow the diagnosis of AMI fastest, optimizing at the same time, the results of reperfusion therapy [7,8]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
