Myocardial infarction in the presence of left bundle branch block pattern. A: Prior to acute infarction. A left bundle branch block pattern is present;

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Presentation transcript:

Myocardial infarction in the presence of left bundle branch block pattern. A: Prior to acute infarction. A left bundle branch block pattern is present; note the q wave in lead aVL, which suggests anterior infarction or a component of peri-infarction conduction delay. B: Recorded during an episode of severe chest pain. ST-segment elevation is present in leads I, aVL, and V5. Independent confirmation of myocardial infarction is required. (In this patient, infarction was confirmed by diagnostic elevations of serum creatine kinase MB fractions.) (Reproduced, with permission, from Goldschlager N, Goldman MJ. Principles of Clinical Electrocardiography, 13th ed. Originally published by Appleton & Lange. Copyright © 1989 by The McGraw-Hill Companies, Inc.) Source: Heart Disease, Current Medical Diagnosis & Treatment 2018 Citation: Papadakis MA, McPhee SJ, Rabow MW. Current Medical Diagnosis & Treatment 2018; 2017 Available at: http://accessmedicine.mhmedical.com/DownloadImage.aspx?image=/data/books/2192/cmdt18_ch10_ef070-1.png&sec=168191519&BookID=2192&ChapterSecID=168190671&imagename= Accessed: October 11, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved