Sunday 18 September 2011

Acute myocardial infarction in the presence of left bundle branch block



A 79 year old man with 5 hours of chest pain.

Acute myocardial infarction in the presence of left bundle branch block

Features suggesting acute MI

  • ST changes in the same direction as the QRS (as shown here)
  • ST elevation more than you'd expect from LBBB alone (e.g. > 5 mm in leads V1 - 3)
  • Q waves in two consecutive lateral leads (indicating anteroseptal MI)

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