tag:blogger.com,1999:blog-549949223388475481.post8999223239214192950..comments2024-03-28T14:02:08.119-05:00Comments on Dr. Smith's ECG Blog: LBBB: is there STEMI?Unknownnoreply@blogger.comBlogger7125tag:blogger.com,1999:blog-549949223388475481.post-66911426041503853132019-07-11T15:07:23.696-05:002019-07-11T15:07:23.696-05:00EXCELLENT BLOGEXCELLENT BLOGDR.GADHAMSETTY MDhttps://www.blogger.com/profile/09560601610581779485noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-79631646535151086912014-07-20T07:29:28.102-05:002014-07-20T07:29:28.102-05:00By most definitions of LBBB, you're correct, a...By most definitions of LBBB, you're correct, and this should be called an nonspecific intraventricular conduction delay. However, that LBBB cannot have Q-waves is not universal. In a great article that has been lost to history, Chapman (of Chapman's sign) found that LBBB often develops Q-waves when the patient undergoes MI. full text: http://circ.ahajournals.org/cgi/reprint/16/4/558<br />In any case, whether IVCD or LBBB, the issue as you say is concordance/discordance, a principle which applies to IVCD as well as LBBB. And in this case the excessive discordance in V4 was the clue to diagnosis of LAD occlusion.Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-47049705306385153222014-07-20T00:20:45.361-05:002014-07-20T00:20:45.361-05:00In LBBB, I thought one of the criteria is the lack...In LBBB, I thought one of the criteria is the lack of q waves in lateral leads. How does that fit in when considering STEMI in LBBB, though I understand the main concept with sgarbossa is discordance and concordance. -JoshAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-74986301578217011172011-06-02T21:30:21.332-05:002011-06-02T21:30:21.332-05:00Actually quite a lot. See our research in the sec...Actually quite a lot. See our research in the second abstract. But this data is preliminary and would need confirmation in other studies. It's just hard to get anyone to study it.Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-31165166641822278182011-06-02T20:04:58.829-05:002011-06-02T20:04:58.829-05:00Dr. Smith... thanks again for the great case.. you...Dr. Smith... thanks again for the great case.. you reference proportionally excessive discordant depression in lead II... i have noticed such before, but have not ever seen that referenced until your post. how much significance do you put in excessively discordant depression?<br />-DavidAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-37146517566916007032011-05-21T16:52:31.635-05:002011-05-21T16:52:31.635-05:00It is indeed Cabrera's sign. Notching of the ...It is indeed Cabrera's sign. Notching of the upstroke of the S-wave in any of leads V3-V5 in LBBB. It is associated with MI in LBBB, but not necessarily with acute MI. Good pickup.Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-3245792290832350592011-05-21T16:23:41.413-05:002011-05-21T16:23:41.413-05:00that looks like cabrera's sign in v3that looks like cabrera's sign in v3mdawarehttps://www.blogger.com/profile/11511273712090189564noreply@blogger.com