Prevalence of acute myocardial infarction in patients with presumably new left bundle-branch block
Abstract Objectives We assessed the prevalence of true acute myocardial infarction and the need for emergent revascularization among patients with new or presumably new left bundle branch block (nLBBB) for whom the primary percutaneous coronary intervention protocol was activated. Methods and Result...
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| Veröffentlicht in: | Journal of electrocardiology 2012-07, Vol.45 (4), p.361-367 |
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| container_title | Journal of electrocardiology |
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| creator | Mehta, Nilay, DO Huang, Henry D., MD Bandeali, Salman, MD Wilson, James M., MD Birnbaum, Yochai, MD |
| description | Abstract Objectives We assessed the prevalence of true acute myocardial infarction and the need for emergent revascularization among patients with new or presumably new left bundle branch block (nLBBB) for whom the primary percutaneous coronary intervention protocol was activated. Methods and Results Among 802 patients, 69 (8.6%) had nLBBB. The chief presenting symptom was chest pain or cardiac arrest in 36 patients (52.2%) and shortness of breath in 15 (21.7%). Less than 30% of the patients had elevated cardiac troponin-I, and less than 10% had elevated creatine kinase–MB. Only 11.6% of the patients underwent emergent revascularization; the rate was higher for patients who presented with chest pain or cardiac arrest or shortness of breath than for patients who presented with other symptoms. Conclusions Acute myocardial infarction and the need for emergent revascularization are relatively uncommon among patients who present with nLBBB, especially when symptoms are atypical. Current guidelines for primary percutaneous coronary intervention protocol activation for nLBBB should be reconsidered. |
| doi_str_mv | 10.1016/j.jelectrocard.2012.04.006 |
| format | Article |
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Methods and Results Among 802 patients, 69 (8.6%) had nLBBB. The chief presenting symptom was chest pain or cardiac arrest in 36 patients (52.2%) and shortness of breath in 15 (21.7%). Less than 30% of the patients had elevated cardiac troponin-I, and less than 10% had elevated creatine kinase–MB. Only 11.6% of the patients underwent emergent revascularization; the rate was higher for patients who presented with chest pain or cardiac arrest or shortness of breath than for patients who presented with other symptoms. Conclusions Acute myocardial infarction and the need for emergent revascularization are relatively uncommon among patients who present with nLBBB, especially when symptoms are atypical. Current guidelines for primary percutaneous coronary intervention protocol activation for nLBBB should be reconsidered.</description><identifier>ISSN: 0022-0736</identifier><identifier>EISSN: 1532-8430</identifier><identifier>DOI: 10.1016/j.jelectrocard.2012.04.006</identifier><identifier>PMID: 22575807</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Acute myocardial infarction ; Aged ; Angioplasty, Balloon, Coronary ; Bundle-Branch Block - complications ; Bundle-Branch Block - diagnosis ; Bundle-Branch Block - therapy ; Cardiovascular ; Creatine Kinase, MB Form - blood ; Electrocardiogram ; Electrocardiography ; Emergencies ; Female ; Humans ; Left bundle branch block ; Male ; Myocardial Infarction - complications ; Myocardial Infarction - diagnosis ; Myocardial Infarction - therapy ; Primary percutaneous coronary intervention ; Troponin I - blood</subject><ispartof>Journal of electrocardiology, 2012-07, Vol.45 (4), p.361-367</ispartof><rights>Elsevier Inc.</rights><rights>2012 Elsevier Inc.</rights><rights>Copyright © 2012 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c435t-59a3053b18fbfff84fc001efdfdc4fb79f6a584b53f16cff5773007b2cb96bd13</citedby><cites>FETCH-LOGICAL-c435t-59a3053b18fbfff84fc001efdfdc4fb79f6a584b53f16cff5773007b2cb96bd13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jelectrocard.2012.04.006$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,45994</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22575807$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mehta, Nilay, DO</creatorcontrib><creatorcontrib>Huang, Henry D., MD</creatorcontrib><creatorcontrib>Bandeali, Salman, MD</creatorcontrib><creatorcontrib>Wilson, James M., MD</creatorcontrib><creatorcontrib>Birnbaum, Yochai, MD</creatorcontrib><title>Prevalence of acute myocardial infarction in patients with presumably new left bundle-branch block</title><title>Journal of electrocardiology</title><addtitle>J Electrocardiol</addtitle><description>Abstract Objectives We assessed the prevalence of true acute myocardial infarction and the need for emergent revascularization among patients with new or presumably new left bundle branch block (nLBBB) for whom the primary percutaneous coronary intervention protocol was activated. Methods and Results Among 802 patients, 69 (8.6%) had nLBBB. The chief presenting symptom was chest pain or cardiac arrest in 36 patients (52.2%) and shortness of breath in 15 (21.7%). Less than 30% of the patients had elevated cardiac troponin-I, and less than 10% had elevated creatine kinase–MB. Only 11.6% of the patients underwent emergent revascularization; the rate was higher for patients who presented with chest pain or cardiac arrest or shortness of breath than for patients who presented with other symptoms. Conclusions Acute myocardial infarction and the need for emergent revascularization are relatively uncommon among patients who present with nLBBB, especially when symptoms are atypical. Current guidelines for primary percutaneous coronary intervention protocol activation for nLBBB should be reconsidered.</description><subject>Acute myocardial infarction</subject><subject>Aged</subject><subject>Angioplasty, Balloon, Coronary</subject><subject>Bundle-Branch Block - complications</subject><subject>Bundle-Branch Block - diagnosis</subject><subject>Bundle-Branch Block - therapy</subject><subject>Cardiovascular</subject><subject>Creatine Kinase, MB Form - blood</subject><subject>Electrocardiogram</subject><subject>Electrocardiography</subject><subject>Emergencies</subject><subject>Female</subject><subject>Humans</subject><subject>Left bundle branch block</subject><subject>Male</subject><subject>Myocardial Infarction - complications</subject><subject>Myocardial Infarction - diagnosis</subject><subject>Myocardial Infarction - therapy</subject><subject>Primary percutaneous coronary intervention</subject><subject>Troponin I - blood</subject><issn>0022-0736</issn><issn>1532-8430</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkU1rFTEUhoMo9lr9CxJcuZnxJJlPF4K0fhQKFdR1SDInNNNM5prMtNx_34y3inQlBJLF876HPIeQNwxKBqx5N5YjejRLnI2KQ8mB8RKqEqB5QnasFrzoKgFPyQ6A8wJa0ZyQFymNANDzlj8nJ5zXbd1BuyP6W8Rb5TEYpLOlyqwL0unwu9kpT12wKprFzSE_6V4tDsOS6J1bruk-Ylonpf2BBryjHu1C9RoGj4WOKphrqv1sbl6SZ1b5hK8e7lPy8_OnH2dfi8urLxdnHy8LU4l6KepeCaiFZp3V1tqusgaAoR3sYCqr2942qu4qXQvLGmNt3bYCoNXc6L7RAxOn5O2xdx_nXyumRU4uGfReBZzXJBlw1nf59Bl9f0RNnFOKaOU-uknFQ4bk5liO8l_HcnMsoZLZcQ6_fpiz6gmHv9E_UjNwfgQw__bWYZTJuM3w4GKulMPs_m_Oh0c1xrvgjPI3eMA0zmsM2adkMuWM_L5te1s249kb7zpxD_Hnq0o</recordid><startdate>20120701</startdate><enddate>20120701</enddate><creator>Mehta, Nilay, DO</creator><creator>Huang, Henry D., MD</creator><creator>Bandeali, Salman, MD</creator><creator>Wilson, James M., MD</creator><creator>Birnbaum, Yochai, MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20120701</creationdate><title>Prevalence of acute myocardial infarction in patients with presumably new left bundle-branch block</title><author>Mehta, Nilay, DO ; Huang, Henry D., MD ; Bandeali, Salman, MD ; Wilson, James M., MD ; Birnbaum, Yochai, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c435t-59a3053b18fbfff84fc001efdfdc4fb79f6a584b53f16cff5773007b2cb96bd13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Acute myocardial infarction</topic><topic>Aged</topic><topic>Angioplasty, Balloon, Coronary</topic><topic>Bundle-Branch Block - complications</topic><topic>Bundle-Branch Block - diagnosis</topic><topic>Bundle-Branch Block - therapy</topic><topic>Cardiovascular</topic><topic>Creatine Kinase, MB Form - blood</topic><topic>Electrocardiogram</topic><topic>Electrocardiography</topic><topic>Emergencies</topic><topic>Female</topic><topic>Humans</topic><topic>Left bundle branch block</topic><topic>Male</topic><topic>Myocardial Infarction - complications</topic><topic>Myocardial Infarction - diagnosis</topic><topic>Myocardial Infarction - therapy</topic><topic>Primary percutaneous coronary intervention</topic><topic>Troponin I - blood</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mehta, Nilay, DO</creatorcontrib><creatorcontrib>Huang, Henry D., MD</creatorcontrib><creatorcontrib>Bandeali, Salman, MD</creatorcontrib><creatorcontrib>Wilson, James M., MD</creatorcontrib><creatorcontrib>Birnbaum, Yochai, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of electrocardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mehta, Nilay, DO</au><au>Huang, Henry D., MD</au><au>Bandeali, Salman, MD</au><au>Wilson, James M., MD</au><au>Birnbaum, Yochai, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence of acute myocardial infarction in patients with presumably new left bundle-branch block</atitle><jtitle>Journal of electrocardiology</jtitle><addtitle>J Electrocardiol</addtitle><date>2012-07-01</date><risdate>2012</risdate><volume>45</volume><issue>4</issue><spage>361</spage><epage>367</epage><pages>361-367</pages><issn>0022-0736</issn><eissn>1532-8430</eissn><abstract>Abstract Objectives We assessed the prevalence of true acute myocardial infarction and the need for emergent revascularization among patients with new or presumably new left bundle branch block (nLBBB) for whom the primary percutaneous coronary intervention protocol was activated. Methods and Results Among 802 patients, 69 (8.6%) had nLBBB. The chief presenting symptom was chest pain or cardiac arrest in 36 patients (52.2%) and shortness of breath in 15 (21.7%). Less than 30% of the patients had elevated cardiac troponin-I, and less than 10% had elevated creatine kinase–MB. Only 11.6% of the patients underwent emergent revascularization; the rate was higher for patients who presented with chest pain or cardiac arrest or shortness of breath than for patients who presented with other symptoms. Conclusions Acute myocardial infarction and the need for emergent revascularization are relatively uncommon among patients who present with nLBBB, especially when symptoms are atypical. Current guidelines for primary percutaneous coronary intervention protocol activation for nLBBB should be reconsidered.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>22575807</pmid><doi>10.1016/j.jelectrocard.2012.04.006</doi><tpages>7</tpages></addata></record> |
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| subjects | Acute myocardial infarction Aged Angioplasty, Balloon, Coronary Bundle-Branch Block - complications Bundle-Branch Block - diagnosis Bundle-Branch Block - therapy Cardiovascular Creatine Kinase, MB Form - blood Electrocardiogram Electrocardiography Emergencies Female Humans Left bundle branch block Male Myocardial Infarction - complications Myocardial Infarction - diagnosis Myocardial Infarction - therapy Primary percutaneous coronary intervention Troponin I - blood |
| title | Prevalence of acute myocardial infarction in patients with presumably new left bundle-branch block |
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