Patients with LBBB of unknown onset presenting with chest pain can pose a diagnostic challenge in the ED while Smith-Modified-Sgarbossa (SMS) ECG criteria might facilitate AMI diagnosis. We demonstrate a case of a 79-year-old man that presented to the ED with chest pain. ⋯ The coronary angiogram showed the total occlusion of the culprit left anterior descending artery. In this case, awareness of SMS criteria aided in the early prehospital diagnosis of AMI in the setting of LBBB and impacted the course of treatment.
Josip A Borovac, Ana Orsolic, Dino Miric, and Duska Glavas.
Department of Pathophysiology, University of Split School of Medicine (MEFST), Soltanska 2, 21000 Split, Croatia; Institute of Emergency Medicine of Split-Dalmatia County (ZHM SDZ), Spinciceva 1, 21000 Spl... more it, Croatia. Electronic address: jborovac@mefst.hr. less