Acute myocardial infarction with left bundle branch block [LBBB]: significance of sgarbossa criteria

ABSTRACT

A middle aged female presented in emergency department with chest discomfort. Her old electrocardiogram [EKG] showed left bundle branch block [LBBB] signs. EKG performed in the emergency room revealed left bundle branch block with 4-6 mm discordant ST segment elevation in leads VI-V3 and 1mm concordant ST segment elevation in lead V4. Diagnosis of acute anterior wall STEMI was made based on Sgarbossa criteria. She underwent angiography which showed total occlusion of proximal left anterior descending artery which was stented. She had uneventful post-stenting course in hospital and was discharged. The case highlights the significance of Sgarbossa criteria which can be applied to diagnose acute myocardial infarction in the presence of LBBB so that prompt thrombolytic or primary angioplasty can be preformed