Electrocardiographic signs of acute myocardial infarction in left bundle branch block

INTRODUCTION

Acute myocardial infarction is characterized by typical chest pain, electrocardiographic changes in terms of lesion and/or myocardial ischemia and increased cardiac enzymes. It is often difficult to make diagnosis in the presence of non-specific chest pain, the short duration of symptoms and electrocardiographic signs of a complete left bundle branch block.

LITERATURE REVIEW

Many authors have tried to set the electrocardiographic criteria that can increase the possibility of correct diagnosis of acute myocardial infarction in such situations. The most widely used and recognized criterion is Sgarbossa scoring system that includes concordant ST segment elevation > 1 mm ST segment, disconcordant denivelation of ST segment > 1 mm in the leads V1-V3 and disconcordant ST segment elevation > 5 mm with acceptable sensitivity and specificity. In subsequent studies, the sensitivity and specificity increased by replacing the third criterion with ST/S ratio < -0.25.

CONCLUSION

The knowledge of certain electrocardiographic signs in patients with acute coronary syndrome and left bundle branch block increases the chances of early diagnosis and the possibility of better and timely treatment.

Left ventricular diastolic dysfunction in patients with metabolic syndrome

Metabolic syndrome (MetS), which is a cluster of medical disorders, is common and it is associated with increased cardiovascular morbidity and mortality. The aim of this study was to evaluate the relationship between characteristics of metabolic syndrome and the grade of diastolic dysfunction. The study included 72 patients (29 male and 43 female), who had central obesity and at least two of the other four characteristics of metabolic syndrome according to IDF (International Diabetes Federation) criteria. The exclusion criteria were age above 65, impaired systolic function (left ventricular ejection fraction < 55%) atrial fibrillation, valvular and pericardial heart disease. Diastolic function was determined according to the criteria of the American Society of Echocardiography. There was a positive correlation between the number of characteristics of metabolic syndrome and the diastolic dysfunction grade (p < 0.0001). The positive correlation was found between the grade of diastolic dysfunction and the waist circumference (p < 0.0001), arterial hypertension (p < 0.001). pared glucose tolerance/diabetes (P = 0.0063), and hypertriglyceridemia (p = 0.0262). A low level of high-density lipoprotein did not show a statistically significant correlation. The presence of metabolic syndrome is associated with the presence of diastolic dysfunction. The grade of diastolic dysfunction is dependent on the number of coexisting characteristics of metabolic syndrome. Arterial hypertension, central obesity, hyperglycemia and hypertriglyceridemia showed a significant correlation with the degree of diastolic dysfunction.