Diagnosing Acute Coronary Syndrome in Presence of Left Bundle Branch Block- A Case Report

Left bundle branch block (LBBB) makes ECG interpretation difficult in acute coronary syndrome. Sgarbossa criteria is usually used for diagnosing myocardial infarction in presence of LBBB. However not all patients fulfil this criterion. Our case, a 66 year old hypertensive & diabetic male who was finally diagnosed as acute coronary syndrome did not fulfil Sgarbossa & modified Sgarbossa criteria. Hence we need a comprehensive ECG analysis in patients with chest pain & new or presumably new onset LBBB. Our algorithmic approach that is demonstrated in our case report, combines multiple criteria with different sensitivities and specificities and can be valuable in diagnosing myocardial infarction in presence of LBBB.