Why the study?
Identifying acute MI in the setting of left bundle branch block is challenging, making it critical to determine which patients require urgent reperfusion therapy.
Can paramedics effectively use the Smith-modified Sgarbossa criteria to identify acute myocardial infarction in patients with left bundle branch block?
Can paramedics effectively use the Smith-modified Sgarbossa criteria to identify acute myocardial infarction in patients with left bundle branch block?
Paramedics can successfully apply the Smith-modified Sgarbossa criteria in the prehospital setting to identify acute myocardial infarction in patients with LBBB, facilitating timely reperfusion therapy.
May support prehospital LBBB evaluation by paramedics; hypothesis-generating case report requiring prospective validation before practice change.
Identifying acute MI in the setting of left bundle branch block (LBBB) is challenging because ST-segment elevation is often found at baseline. When faced with LBBB and ischemic symptoms, identifying which patients require urgent reperfusion therapy is critical. Sgarbossa et al. derived three criteria that can be used to help identify these patients, Smith et al. refined these criteria creating the Smith-modified Sgarbossa criteria. We present a case of LBBB meeting the Smith-modified Sgarbossa criteria, recognized by paramedics and used to activate the catheterization laboratory after normal business hours. The patient was found with 95% stenosis of the left anterior descending artery and received stenting.
No takes yet. Share an insight, caveat, or question.
Toro et al. (2020) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: