title: Electrocardiographic signs of acute myocardial infarction in left bundle branch block.
abstract: BACKGROUND
  Acute myocardial infarction is characterized by typical chest pain, electrocardiographic changes in terms of lesion and/or myocardial ischemia and increased cardiac enzymes. It is often difficult to make diagnosis in the presence of non-specific chest pain, the short duration of symptoms and electrocardiographic signs of a complete left bundle branch block.
  
  
  METHODS
  Many authors have tried to set the electrocardiographic criteria that can increase the possibility of correct diagnosis of acute myocardial infarction in such situations. The most widely used and recognized criterion is Sgarbossa scoring system that includes concordant ST segment elevation > 1 mm ST segment, disconcordant denivelation of ST segment > 1 mm in the leads V1-V3 and disconcordant ST segment elevation > 5 mm with acceptable sensitivity and specificity. In subsequent studies, the sensitivity and specificity increased by replacing the third criterion with ST/S ratio < -0.25.
  
  
  CONCLUSIONS
  The knowledge of certain electrocardiographic signs in patients with acute coronary syndrome and left bundle branch block increases the chances of early diagnosis and the possibility of better and timely treatment.
authors.affiliation: Institute for Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia. ivanovigor05@gmail.com
authors.forename: Igor
authors.initials: I
authors.lastname: Ivanov
authors.affiliation: Institute for Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia.
authors.forename: Sonja
authors.initials: S
authors.lastname: Bugarski
authors.affiliation: Institute for Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia.
authors.forename: Jadranka
authors.initials: J
authors.lastname: Dejanović
authors.affiliation: Institute for Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia.
authors.forename: Anastazija
authors.initials: A
authors.lastname: Stojsić Milosavljević
authors.affiliation: Institute for Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia.
authors.forename: Jasna
authors.initials: J
authors.lastname: Radisić Bosić
authors.affiliation: Institute for Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia.
authors.forename: Bojan
authors.initials: B
authors.lastname: Vujin
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000503:physiopathology; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000503:physiopathology; D053840:Brugada Syndrome; D002037:Bundle-Branch Block / Q000175:diagnosis* / Q000503:physiopathology; D000075224:Cardiac Conduction System Disease; D004562:Electrocardiography; D006329:Heart Conduction System / Q000002:abnormalities / Q000503:physiopathology; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000503:physiopathology; D012680:Sensitivity and Specificity