PMID- 32148969
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200928
IS  - 2090-6404 (Print)
IS  - 2090-6412 (Electronic)
IS  - 2090-6404 (Linking)
VI  - 2020
DP  - 2020
TI  - Left Bundle Branch Block Chest Pain Conundrum.
PG  - 2724981
LID - 10.1155/2020/2724981 [doi]
LID - 2724981
AB  - Left bundle branch block is a pattern of altered ventricular depolarization and 
      subsequently affects repolarization. These obscure patterns can affect the 
      traditional ST segment shift criteria for the electrocardiographic detection of 
      coronary insufficiency syndromes. Previously, patients with coronary ischemic 
      pain and LBBB judged to be "new" (not previously documented) were considered to 
      have ST elevation myocardial infarction (STEMI) warranting acute thrombolytic 
      therapy. Current STEMI management favors emergent invasive angiography; however, 
      recent data suggests the prevalence of coronary obstructive pathology may be as 
      low as 50%. The application of more specific, less-sensitive Sgarbossa 
      electrocardiographic criteria may reduce angiographic assessment in an otherwise 
      high-risk population unlikely to tolerate further myocardial injury. We present a 
      case that may facilitate a more nuanced EKG-based approach to distinguish those 
      who may benefit from acute invasive angiography while reducing the frequency of 
      unnecessary angiographic evaluation.
CI  - Copyright (c) 2020 Karthik Seetharam et al.
FAU - Seetharam, Karthik
AU  - Seetharam K
AUID- ORCID: 0000-0001-8006-6445
AD  - Division of Cardiology, St. John's Episcopal Hospital-South Shore, New York, New 
      York, USA.
FAU - Cheema, Ayesha
AU  - Cheema A
AD  - Division of Cardiology, St. John's Episcopal Hospital-South Shore, New York, New 
      York, USA.
FAU - Friedman, Gary
AU  - Friedman G
AD  - Division of Cardiology, St. John's Episcopal Hospital-South Shore, New York, New 
      York, USA.
FAU - Pachulski, Roman
AU  - Pachulski R
AUID- ORCID: 0000-0002-3568-5850
AD  - Division of Cardiology, St. John's Episcopal Hospital-South Shore, New York, New 
      York, USA.
LA  - eng
PT  - Case Reports
DEP - 20200219
PL  - United States
TA  - Case Rep Cardiol
JT  - Case reports in cardiology
JID - 101576452
PMC - PMC7053445
COIS- The authors declare that they have no conflicts of interest.
EDAT- 2020/03/10 06:00
MHDA- 2020/03/10 06:01
PMCR- 2020/02/19
CRDT- 2020/03/10 06:00
PHST- 2019/09/15 00:00 [received]
PHST- 2020/01/21 00:00 [revised]
PHST- 2020/01/30 00:00 [accepted]
PHST- 2020/03/10 06:00 [entrez]
PHST- 2020/03/10 06:00 [pubmed]
PHST- 2020/03/10 06:01 [medline]
PHST- 2020/02/19 00:00 [pmc-release]
AID - 10.1155/2020/2724981 [doi]
PST - epublish
SO  - Case Rep Cardiol. 2020 Feb 19;2020:2724981. doi: 10.1155/2020/2724981. 
      eCollection 2020.