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Khawaja M, Thakker J, Kherallah R, Ye Y, Smith SW, Birnbaum Y. Diagnosis of Occlusion Myocardial Infarction in Patients with Left Bundle Branch Block and Paced Rhythms. Curr Cardiol Rep 2021; 23:187. [PMID: 34791609 DOI: 10.1007/s11886-021-01613-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/01/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE OF REVIEW A number of criteria have been developed to aid with the diagnosis of occlusion myocardial infarction (OMI) in patients with left bundle branch block (LBBB) and ventricular paced rhythms (VPR). The current guidelines do not provide clear preference for any specific ECG criteria in LBBB and paced rhythm patients. RECENT FINDINGS This review delineates the difficulties of electrocardiographic diagnosis of OMI in both LBBB and VPR patients. We describe the original Sgarbossa and the newer criteria and their diagnostic performances. We highlight the expected changes of newer pacing modalities and how they may interfere with the electrocardiographic diagnosis of OMI. We recommend utilizing the Cai et al. algorithm, which combines clinical assessment with the Smith Modified Sgarbossa ECG criteria, for both LBBB and right ventricular pacing patients with suspected OMI. There is limited data concerning ECG changes of OMI in patients with the newer pacing modalities, such as biventricular, His-bundle, or left bundle branch pacing.
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Affiliation(s)
- Muzamil Khawaja
- Department of Medicine, Baylor College of Medicine, Houston, USA
| | - Janki Thakker
- Department of Medicine, Baylor College of Medicine, Houston, USA
| | - Riyad Kherallah
- Department of Medicine, Baylor College of Medicine, Houston, USA
| | - Yumei Ye
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, USA
| | - Stephen W Smith
- Department of Emergency Medicine, Hennepin Healthcare and the University of Minnesota School of Medicine, 701 S. Park Ave. Minneapolis, Minnesota, MN, 55415, USA.
| | - Yochai Birnbaum
- Section of Cardiology, Department of Medicine, Baylor College of Medicine, MS: BCM620. One Baylor Plaza, Houston, TX, 77030, USA.
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Demoulin R, Poyet R, Schmitt P, Sidibe S, Capilla E, Rohel G, Pons F, Jego C, Brocq FX, Druelle A, Cellarier GR. [Particularities of African descent patient's electrocardiogram]. Ann Cardiol Angeiol (Paris) 2020; 69:289-293. [PMID: 33039116 DOI: 10.1016/j.ancard.2020.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 09/03/2020] [Indexed: 06/11/2023]
Abstract
Particularities of African descent patient's electrocardiogram have been described for many years. Variations such as higher QRS voltage, early repolarization pattern, precordial T-wave inversion and anterior ST segment elevation associated with T-wave inversion are more frequently observed. Ignorance of these variations can lead to misdiagnosis or therapeutic negligence. We present the electrocardiographic particularities attributed to the patient of African origin.
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Affiliation(s)
- R Demoulin
- Service de cardiologie et maladies vasculaires, hôpital d'instruction des armées Sainte-Anne, 2, boulevard Sainte-Anne, 83000 Toulon, France.
| | - R Poyet
- Service de cardiologie et maladies vasculaires, hôpital d'instruction des armées Sainte-Anne, 2, boulevard Sainte-Anne, 83000 Toulon, France
| | - P Schmitt
- Service de cardiologie et maladies vasculaires, hôpital d'instruction des armées Sainte-Anne, 2, boulevard Sainte-Anne, 83000 Toulon, France
| | - S Sidibe
- Service de cardiologie et maladies vasculaires, hôpital d'instruction des armées Sainte-Anne, 2, boulevard Sainte-Anne, 83000 Toulon, France; Healthcare Department of the Malian Armed Forces, Mali
| | - E Capilla
- Service de cardiologie et maladies vasculaires, hôpital d'instruction des armées Sainte-Anne, 2, boulevard Sainte-Anne, 83000 Toulon, France
| | - G Rohel
- Service de cardiologie et maladies vasculaires, hôpital d'instruction des armées Sainte-Anne, 2, boulevard Sainte-Anne, 83000 Toulon, France
| | - F Pons
- Service de cardiologie et maladies vasculaires, hôpital d'instruction des armées Sainte-Anne, 2, boulevard Sainte-Anne, 83000 Toulon, France
| | - C Jego
- Service de cardiologie et maladies vasculaires, hôpital d'instruction des armées Sainte-Anne, 2, boulevard Sainte-Anne, 83000 Toulon, France
| | - F X Brocq
- Centre d'expertise médicale du personnel naviguant, hôpital d'instruction des armées Sainte-Anne, 2, boulevard Sainte-Anne, 83000 Toulon, France
| | - A Druelle
- Service de médecine hyperbare et expertise de la plongée, hôpital d'instruction des armées Sainte-Anne, Toulon, France
| | - G R Cellarier
- Service de cardiologie et maladies vasculaires, hôpital d'instruction des armées Sainte-Anne, 2, boulevard Sainte-Anne, 83000 Toulon, France
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Kalinauskiene E, Balnyte R, Naudziunas A. A constant ST segment elevation in leads II, III, AVF: An electrocardiographic, echocardiographic, clinical, exercise test, laboratory and multi-slice computed tomography angiographic study. J Electrocardiol 2016; 49:610-3. [PMID: 27212143 DOI: 10.1016/j.jelectrocard.2016.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Indexed: 10/21/2022]
Abstract
A constant ST-elevation was more often described in precordial leads. We presented it in leads II, III, AVF in 16 consecutive patients seeking to establish a link between it and clinical, laboratory, echocardiography, exercise test, and multi-slice computed tomography angiography data. Main complaint of these obese middle-age men was angina pectoris (68.75%). They usually had hypertension, dyslipidemia, concentric left ventricular hypertrophy and non-pathological exercise test. Coronary stenosis >50% was only in one case (6.25%). Despite the typical pain and risk factors, the constant ST-elevation in leads II, III, AVF usually was not associated with coronary stenosis.
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Affiliation(s)
- Egle Kalinauskiene
- Department of Internal Diseases, Lithuanian University of Health Sciences, Josvainiu 2, Kaunas, Lithuania.
| | - Ruta Balnyte
- Department of Internal Diseases, Lithuanian University of Health Sciences, Josvainiu 2, Kaunas, Lithuania
| | - Albinas Naudziunas
- Department of Internal Diseases, Lithuanian University of Health Sciences, Josvainiu 2, Kaunas, Lithuania
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