LBBB masking the ECG changes of inferior wall infarction: a caution to be vigilant

Video 1 Apical two chambered view showing significant inferior wall hypokinesia. media-1 bcr-2014-205095.v1 10.1136/bcr-2014-205095v1 Video 2 Parasternal short axis view showing inferior wall hypokinesia. media-2 bcr-2014-205095.v2 10.1136/bcr-2014-205095v2 Video 3 LAO view showing acute thrombotic occlusion of the proximal RCA. media-3 bcr-2014-205095.v3 10.1136/bcr-2014-205095v3 Video 4 LAO view showing successful revascularisation of the RCA after the primary. media-4 bcr-2014-205095.v4 10.1136/bcr-2014-205095v4 This case highlights the importance of this variation in ECG and also highlights the role of echocardiography and angiography in facilitating the correct diagnosis .This case stresses the fact that in patients with pre-existing LBBB more reliance should be placed on other modalities to diagnose an infarct to enable the appropriate treatment to be administered without wasting crucial time to salvage the threatened myocardium.