Can myocardial infarction be rapidly identified in emergency department patients who have left bundle-branch block?

Kontos, Michael C.; McQueen, Robert H.; Jesse, Robert L.; Tatum, James L.; Ornato, Joseph P.

doi:10.1067/mem.2001.114900

Cited by 74 publications

(43 citation statements)

References 30 publications

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“…Sgarbossa criteria could aid in diagnosing LBBB myocardial infarction but when applied in cohorts of all-comers the Sgarbossa criteria suffice with resulting low sensitivity [34][35][36]. Other ECG changes associated to high risk STEMI are the "de Winter T-waves" [37], "Wellens' Syndrome" [38], global ischemia associated with acute left main artery occlusions [39], anterior ST segment depression in posterior STEMI, and patients with paced rhythm.…”

Section: Prehospital Ecg Diagnosis Of Patients With St Elevation Myocmentioning

confidence: 99%

Prehospital diagnosis of patients with acute myocardial infarction

et al. 2016

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Primary percutaneous intervention (PPCI) is the preferred treatment in patients with ST elevation myocardial infarction (STEMI) if this can be performed in a timely manner. The 2012 ESC Guidelines on management of AMI in patients presenting with ST-segment elevation advice that PPCI should be performed within 120 min of first medical contact. Prehospital diagnosis of patients with STEMI is performed to save time and make PPCI available to the majority of patients. Although diagnosing patients with STEMI is usually easy, there are important pitfalls and patients with STEMI are missed on occasion. In addition, it is well know that patients without ST elevation may also have a high-risk cardiac condition. The 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation stress the importance of urgent CAG in patients with high-risk non ST-segment elevation myocardial infarction (NSTEMI). Unfortunately, these patients are difficult to diagnose in the acute phase and important time may be spend establishing the correct diagnosis. Prehospital biomarker measurement has emerged as a method to gain important additional information. We review the evidence on prehospital diagnosis of patients with STEMI and, In addition, we present the current knowledge on the new diagnostic methods that could have a future role in prehospital rule-in and rule-out of cardiac disease.

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Section: Prehospital Ecg Diagnosis Of Patients With St Elevation Myocmentioning

confidence: 99%

Prehospital diagnosis of patients with acute myocardial infarction

et al. 2016

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“…The clinical utility of the criteria and scoring system of Sgarbossa and colleagues [1] have been validated by other studies, all of which have also demonstrated a high specificity, but some have shown an even lower sensitivity than the original data of Sgarbossa and colleagues [1] in terms of the three individual ST-segment criteria and the scoring algorithm [8,[16][17][18][19][20][21]. As such, although the criteria and the algorithm cannot be used to rule out MI, it can help to rule it in.…”

Section: Clinical Implications Of the Sgarbossa Criteriamentioning

confidence: 91%

Electrocardiographic Diagnosis of Myocardial Infarction during Left Bundle Branch Block

Barold

Herweg

2006

Cardiology Clinics

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“…Despite the evolving LBBB, a sign of AMI and indication for thrombolytic treatment [3], coronary angiography failed to demonstrate significant coronary artery disease. On aggregate, the ECG has only moderate sensitivity and specificity for AMI, 81 and 69%, respectively [2].…”

Section: Discussionmentioning

confidence: 99%

“…On aggregate, the ECG has only moderate sensitivity and specificity for AMI, 81 and 69%, respectively [2]. A new LBBB has reportedly lower sensitivity and specificity, 42 and 65%, respectively [3].…”

Section: Discussionmentioning

confidence: 99%

A case of acute pancreatitis presenting with electrocardiographic signs of acute myocardial infarction

Riegert–Johnson

2003

Pancreatology

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Can myocardial infarction be rapidly identified in emergency department patients who have left bundle-branch block?

Cited by 74 publications

References 30 publications

Prehospital diagnosis of patients with acute myocardial infarction

Prehospital diagnosis of patients with acute myocardial infarction

Electrocardiographic Diagnosis of Myocardial Infarction during Left Bundle Branch Block

A case of acute pancreatitis presenting with electrocardiographic signs of acute myocardial infarction

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