LBBB with MI present?

by 12leadekg on March 1, 2011

Is this a STEMI or is this normal for a LBBB?





 









There are several criteria s to determine if a BBB is present and if so which one, Left or Right? First QRS has to equal to or be > .12mm wide. We can use the turn signal method In lead V1 to see which way the QRS terminates. If it terminates down it would be a LBBB and if it terminated up it would be a RBBB. If you choose, you can use the rabbit-ear method to determine Left or Right BBB. If you see rabbit-ear patten (RSR’) in Leads V1 and V2 it would then most likely be a RBBB. If you were to see rabbit-ear pattern (RSR’) in leads V5 and V6 then it is most likely a LBBB. Although V1 is not shown here this is indeed a LBBB.
Now that we know we have a LBBB we now need to try to determine if we have a MI with this LBBB as well. One thing we know is that a LBBB is a huge STEMI Imposter. This means that there will probably be ST elevations present. What do you think about these elevations?