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Criteria for Acute Myocardial Infarction in the Left Bundle Branch Block

In the Emergency Department, the diagnosis of acute myocardial infarction (AMI) relies initially on a patient’s history and the 12-lead electrocardiogram (ECG). Establishing the diagnosis of AMI in the left bundle branch block (LBBB) is difficult and can result in delay of definitive treatment. In 1996, Sgarbossa found 3 ECG criteria to evaluate for AMI in patients with LBBB. Continue reading “Criteria for Acute Myocardial Infarction in the Left Bundle Branch Block”

Electrocardiographic Diagnosis of Left Ventricular Hypertrophy (LVH)

Sokolow-Lyon index:

There are two criteria with these widely used indices:

* Sum of S wave in V1 and R wave in V5 or V6 >/= 3.5 mV (35 mm)

and/or

* R wave in aVL >/= 1.1 mV (11 mm)

Continue reading “Electrocardiographic Diagnosis of Left Ventricular Hypertrophy (LVH)”

Common Diagnostic Criteria for Left and Right Atrial Abnormalities

Left Atrial Abnormality

  • Prolonged P wave duration of >120 msec in lead II
  • Prominent notching of the P wave, usually most obvious in lead II, with an interval between the notches of >40 msec (p mitrale)
  • Ratio between the duration of the P wave in lead II and the duration of the PR segment of >1.6
  • Increased duration and depth of the terminal negative portion of the P wave in lead V1 (the P terminal force) so that the area subtended by it exceeds 0.04 mm-sec (Morris index)
  • Leftward shift of the mean P wave axis to between -30 and +45 degrees Continue reading “Common Diagnostic Criteria for Left and Right Atrial Abnormalities”
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