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  • Title: Managing chest pain in patients with concomitant left bundle-branch block.
    Author: Wyant A, Chatterjee S, Bennett T.
    Journal: JAAPA; 2017 Nov; 30(11):16-21. PubMed ID: 28990972.
    Abstract:
    Diagnosis and timely management of acute myocardial infarction (MI) relies heavily on the ST-segment elevation sum. Presence of concomitant left bundle-branch block (LBBB) in patients presenting with possible acute MI presents a diagnostic dilemma. The LBBB pattern distorts ST-segment changes, delaying or preventing accurate diagnosis. This article reviews the Sgarbossa criteria and ST/S ratio and presents a treatment algorithm that may help improve patient care and reduce morbidity and mortality.
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