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Diagnostics: MI in Left Bundle Branch Block
Diagnostics Ryan LaFollette, MD Diagnostics Ryan LaFollette, MD

Diagnostics: MI in Left Bundle Branch Block

Is the patient in front of you with chest pain and a left bundle branch block an MI? Often the clinical presentation will dictate level of concern, but what about equivocal cases? Join Dr. Walsh as he reviews the diagnostic criteria for MI including Sgarbossa, modified Sgarbossa and a unifying algorithm.

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STEMI and STEMI Equivalents, i.e. Who Needs the Cath Lab Now!
Grand Rounds, Intern Radiology Videos Robert Whitford, MD Grand Rounds, Intern Radiology Videos Robert Whitford, MD

STEMI and STEMI Equivalents, i.e. Who Needs the Cath Lab Now!

1. The ACC/AHA Criteria (1) (2) 

ST-elevation in 2 contiguous leads that is:

  • Men < 40: 2.5 mm ST-elevation in V2 or V3, 1 mm in any other lead

  • Men > 40: 2.0 mm ST-elevation in V2 or V3, 1 mm in any other lead

  • Women: >1.5 mm ST-elevation in V2 or V3, 1 mm in any other lead

STEMI's have a 90-minute door-to-balloon time mandate from the Center for Medicare Services (CMS). To be good stewards of our resources we need to be familiar the false positive STEMI patterns.  Ultimately, however, some degree of over triage and activation for false positives is expected and (potentially even) desirable.

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