Cor Vasa 2019, 61(5):511-513 | DOI: 10.33678/cor.2019.041
New onset left bundle branch block: keep calm!
- a Cardiology, Department of Clinical and Experimental Medicine, University of Messina, Italy
- b Internal Medicine, Department of Clinical and Experimental Medicine, University of Messina, Italy
New onset LBBB represents a STEMI equivalent and, according to the current guidelines, this qualifies for primary angioplasty. However, several conditions could provoke new onset LBBB such as hyperkalemia, hypercalcemia etc. Differential diagnosis is fundamental, especially in emergency condition, in order to avoid unnecessary or harmful treatment. Clinical evaluation and careful analysis of ECG often permitted the correct diagnosis.
Keywords: Hyperkalemia, Kidney failure, Left bundle branch block, Myocardial infarction, STEMI
Accepted: February 9, 2019; Published: October 20, 2019 Show citation
References
- Ibanez B, James S, Agewall S, et al. ESC Scientific Document Group. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J 2018;39:119-177.
Go to original source...
Go to PubMed...
- O'Gara PT, Kushner FG, Ascheim DD, et al. American College of Emergency Physicians; Society for Cardiovascular Angiography and Interventions. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2013;61:e78-e140.
Go to original source...
Go to PubMed...
- Jain S, Ting HT, Bell M, et al. Utility of left bundle branch block as a diagnostic criterion for acute myocardial infarction. Am J Cardiol 2011;107:1111-1116.
Go to original source...
Go to PubMed...
- Sgarbossa EB. Value of the ECG in suspected acute myocardial infarction with left bundle branch block. J Electrocardiol 2000;33(Suppl):87-92.
Go to original source...
Go to PubMed...
- Cheng YT, Su CS, Chang WC, et al. Hypercalcemia-Induced New Onset Left Bundle Branch Block Mimicking Acute Myocardial Infarction in a Patient with Primary Hyperparathyroidism. Acta Cardiol Sin 2013;29:188-191.
- Mattu A, Brady WJ, Robinson DA. Electrocardiographic manifestations of hyperkalemia. Am J Emerg Med 2000;18: 721-729.
Go to original source...
Go to PubMed...
- Littmann L, Monroe MH, Taylor L III, Brearley WD. The hyperkalemic Brugada sign. J Electrocardiol 2007;40:53-59.
Go to original source...
Go to PubMed...
- Ahee P, Crowe AV The management of hyperkalaemia in the emergency department. J Accid Emerg Med 2000;17:188-191.
Go to original source...
Go to PubMed...
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