Mochamad Yusuf Alsagaff, - and Muhammad Dedy Pratama, - and IGN Iswan Rahmadi Ranuh, - and Terrence Timothy Evan Lusida, - (2022) Diagnosing STEMI in right then left bundle branch block pattern ventricular escape rhythm (case report). Oxford Medical Case Reports, 11. ISSN 2053-8855

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Abstract

Electrocardiography is the fastest bedside tool for rapidly identifying patients with acute coronary syndromes who require emergency reperfusion therapy. Some of the circumstances that make identification more complex are bundle branch block patterns. ST elevation in the right bundle branch block (RBBB) can still be detected, but the left bundle branch block (LBBB) must use specific criteria such as Sgarbossa and Barcelona. We present a patient with anteroseptal ST-segment elevation (STEMI), total AV block (TAVB) with ventricular escape rhythm RBBB pattern, and then turned into a LBBB pattern. Fortunately, it immediately turned into sinus rhythm after reperfusion therapy. It is essential to be able to identify STEMI in patients with BBB patterns. In addition, to provide the best possible outcomes for the patient, we must understand that the best way to manage STEMI with TAVB is to immediately install a temporary pacemaker and initiate reperfusion therapy.

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