what criteria determine that an LBBB (new or old) with eleva | Figure 1

forderit

Emergency Medicine

what criteria determine that an LBBB (new or old) with elevated troponin must be treated as STEMI (rather than NSTEMI)?

More about this case

Why you should join Figure 1

Similar cases



Truck driver found sitting at a gas station c/o chest pain for 1 hr before pulling over. 12 lead taken in field is shown. Right side 12 taken and positive. Pt BP 80/40, IV fluids started in field. Pt braided down and needed to be paced in ER. Follow up showed pt had 100% blockage in RCA. No previous cardiac problems other than HTN. Family history of MI.](https://app.figure1.com/case-detail/1bf34796-e5b8-4e03-bc47-fbf700fab363)



75 yr old presented with a cva. Ecg showing this](https://app.figure1.com/case-detail/22e8fc22-403e-44fc-ba03-677923270533)



Worst tombstones I have seen in a long time! pLAD 100%, DES X 1](https://app.figure1.com/case-detail/28223764-a4af-47ff-a65a-fc4e65eae069)



59 Yom cc of chest pain. patient has no major medical history. stated that there had been chest pain x3 days but this pain was different. stated this onset of pain started approximately 4 am. patient placed on the monitor and saw elevation right off the get go (I'm a medic student so I'm still learning all of this). I looked at the medic and stated that something didn't look right but was unsure. strip printed and the medic stated get the patient in the truck and go. vitals were stable en route and cath lab met us at the hospital. my medic states that there is no a-fib just artifact. my medic also sated she did a right sided EKG and found that there was right sided involvement. pt was given asprin by a family member. medic administered fentanyl for pain management. pt vitals were 156/92, pulse 78, resp 18 normal non labored, spo2 100 on ra aa4 and gcs 15.](https://app.figure1.com/case-detail/6a6b3e1d-eeb8-4e8a-9d5a-437c1f3db3b7)

Trending now



A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis.
He had a history of hypertension, long-term smoking, and a sedentary lifestyle.
On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.](https://app.figure1.com/case-detail/ae0fe999-6875-4474-94f0-ad823dbb9b3a)



A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets.
Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.](https://app.figure1.com/case-detail/c271070f-2bc7-4052-9895-635277e1a7d5)



A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.](https://app.figure1.com/case-detail/48f41642-b9db-4089-b120-a94ee52328de)



patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?](https://app.figure1.com/case-detail/2af390e1-ace8-40ed-ba1c-98fb2d72f4c5)