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KMID : 1011920090100020031
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International Journal of Arrhythmia
2009 Volume.10 No. 2 p.31 ~ p.33
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Hyun Dae-Woo
Lee Eun-Gyu
Kim Kun-Young
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Abstract
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The electrocardiogram (ECG) diagnosis of ischemic heart disease is made more difficult in the setting of left bundle branch block (LBBB). Several strategies are available to assist in the correct interpretation of the acute myocardial infarction (AMI) with LBBB, including: ① concordant ST segment elevation ≥1 mm; ② ST segment depression ≥1 mm in lead V1, V2, or V3; and ③ discordant ST segment elevation ≥5 mm. A 74-yearold man presented to the emergency department with chest pain for 3 hours. An ECG showed normal sinus rhythm with LBBB morphology and discordant ST segment elevation ≥5 mm in right precordial leads. Cardiac enzyme levels were elevated and the coronary angiogram showed occlusion of the left anterior descending artery, so we confirmed the diagnosis of AMI.
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KEYWORD
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electrocardiogram, left bundle branch block, myocardial infarction
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Listed journal information
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