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 revealedleft bundle branch block with 4-6 mm discordant ST segment elevation in leads V1-V3 and 1mm concordantST segment elevation in lead V4. Diagnosis o f acute anterior wall STEMI was made based on Sgarbossacriteria. She underwent angiography which showed total occlusion o f proximal left anterior descendingartery which was stented. She had uneventful post-stenting course in hospital and was discharged. The casehighlights the significance of Sgarbossa criteria which can be applied to diagnose acute myocardial infarctionin the presence o f LBBB so th at prompt thrombolytic or primary angioplasty can be preformed.