TODAYS VERSION OF PEARLS OF THE DAY IS A REQUEST FROM DOCTOR BOWEN AND OUR ROYAL NORWEIGAN CHIEF ASTRID "CURED FISH" HAALAND
SGARBOSSA CRITERIA :
another [dumb] eponymous topic (see yesterday's email about Brugada)
BASICS
- Allows you to diagnose cardiac ischemia in a LBBB EKG
- He was probably some old white cardiologist
- IMPORTANT: There are the original criteria and the modified. Today we will be discussing MODIFIED
EKG FINDING IN LBBB (NORMAL)
- Widened QRS, QRS down in V1 and (possibly) up in V6
- Appropriately discordant T-waves
- The T waves will usually be REBELS and don't listen to their parents and go the OPPOSITE WAY of the EVIL QRS. That's what discordant is yo.
- BUT they aren't that bad, they don't want to be like Dr. Bowen and be pure evil, they are usually <5mm (or< 25% of the S wave) in the opposite direction
- NORMAL LBBB EKG
SGARBOSSA CRITERIA (MODIFIED) FOR IDENTIFYING LBBB WITH ISCHEMIA PUT IN TECHNICAL TERMS (SORRY)
- ≥ 1 lead with ≥1 mm of concordant ST elevation
- ≥ 1 lead of V1-V3 with ≥ 1 mm of concordant ST depression
- ≥ 1 lead anywhere excessive discordant STE, (≥ 25% of the depth of the preceding S-wave).
I KNOW, THIS CRAP MAKES NO SENSESO LETS BREAK THIS DOWN INTO THINGS EVEN JB CAN UNDERSTAND - Any ST segment elevation that goes SAME DIRECTION as the QRS is BAD (middle picture above)
- Any ST segment DEPRESSION is BAD (right picture above)
- Any ST segment that goes SUPER OPPOSITE is bad
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THANK YOU FOR READING ALL THESE THINGS THIS WEEK, LOOK FORWARD TO WEEK 2 OF PEARLS OF THE DAY COMING TO AN EMAIL INBOX NEAR YOU NEXT WEEK! ***CROWD GOES WILD WITH APPLAUSE***
