A. Left bundle branch block (LBBB)
Yes! Left bundle branch block (LBBB) is seen as broad and notched R waves in lead V6 (and V5 + aVL). Like with right bundle branch block (RBBB) the duration of the QRS complex ≥ 0.12 seconds. ST segment and repolarization changes are seen, which may rise suspicion of an acute myocardial infarction (AMI) – in particular if the patient has complaints of chest pain. Indeed, LBBB can be caused by an AMI so activation of the cardiac cathetherization lab may very well be indicated. If possible check earlier recordings to establish if the LBBB is new. See more on LBBB in the library.
B. Right bundle branch block (RBBB)
No. In this EKG the QRS complexes are widened (≥ 0.12 sec.) as in RBBB, but there is no rSR’ or “M” configuration in lead V1.
C. Acute anterior myocardial infarction
No. The ST-segment elevations seen are due to a conduction defect. However this conduction defect may be caused by an acute myocardial infarction.
D. Acute inferior myocardial infarction
No. The ST-segment elevations seen are due to a conduction defect. However this conduction defect may be caused by an acute myocardial infarction.
E. Wolff-Parkinson-White (WPW) syndrome
No. The QRS complexes in WPW are also wide (≥ 0.12 sec.). In WPW this is due to pre-excitation of the ventricles and should be accompanied by a shortened PR-interval.
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LBBB
Left Bundle branch block. Sgarbossa criteria not present.