187. Chest Pain and a Confounding Electrocardiogram Pattern

  1. Christopher P. Holstege MD1,2,3,
  2. Alexander B. Baer MD1,4,
  3. Jesse M. Pines MD, MBA, MSCE5,6 and
  4. William J. Brady MD7,8,9

Published Online: 3 AUG 2011

DOI: 10.1002/9781444397994.ch187

Visual Diagnosis in Emergency and Critical Care Medicine, Second Edition

Visual Diagnosis in Emergency and Critical Care Medicine, Second Edition

How to Cite

Holstege, C. P., Baer, A. B., Pines, J. M. and Brady, W. J. (eds) (2011) Chest Pain and a Confounding Electrocardiogram Pattern, in Visual Diagnosis in Emergency and Critical Care Medicine, Second Edition, Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781444397994.ch187

Editor Information

  1. 1

    Division of Medical Toxicology, University of Virginia School of Medicine, Charlottesville, VA, USA

  2. 2

    Blue Ridge Poison Center, University of Virginia School of Medicine, Charlottesville, VA, USA

  3. 3

    Departments of Emergency Medicine & Pediatrics, University of Virginia School of Medicine, Charlottesville, VA, USA

  4. 4

    Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA

  5. 5

    Center for Health Care Quality, George Washington University, Washington, DC, USA

  6. 6

    Departments of Emergency Medicine and Health Policy, George Washington University, Washington, DC, USA

  7. 7

    Department of Emergency Medicine, University of Virginia, Charlottesville, VA, USA

  8. 8

    Center for Emergency Management, University of Virginia Health System, Charlottesville, VA, USA

  9. 9

    Charlottesville-Albemarle Rescue Squad & Albemarle County, Fire Rescue, Charlottesville, VA, USA

Publication History

  1. Published Online: 3 AUG 2011
  2. Published Print: 12 AUG 2011

ISBN Information

Print ISBN: 9781444333473

Online ISBN: 9781444397994

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Keywords:

  • Case 77, chest pain and confounding electrocardiogram pattern;
  • diagnosis - left bundle branch block and acute myocardial infarction;
  • patients with LBBB, and acute myocardial infarction (AMI) - risk of experiencing a poor outcome;
  • patients with AMI, pre-existing and new-onset LBBB - clinical markers for worsened prognosis;
  • rule of appropriate discordance - in LBBB pattern;
  • risk of poor outcome, patients with LBBB - less often, receiving fibrinolytic therapy;
  • LBBB, a confounding pattern - reducing ECG's ability of detecting acute coronary syndrome (ACS);
  • QS pattern of LBBB, in leads - resembling Q waves in infarction;
  • “rule of appropriate discordance” - appropriate ST segment deflections, of QRS complex;
  • approach, to patients with LBBB - and myocardial infarction, complicated

Summary

This chapter contains sections titled:

  • Further reading