Not all new Left Bundle Branch Block (LBBB) requires Cardiac Catheterization Laboratory Activation

Abstract

Presence of concomitant left bundle brunch block (LBBB) in patients presenting with possible acute myocardial infarction (AMI) showcases a unique diagnostic and therapeutic challenge. Current guidelines recommend that patients with new or presumed new LBBB undergo emergency reperfusion therapy. However, only a minority of patients prove to have occluded artery at cardiac catheterization. Alternative strategies have been proposed to triage patients to select those suitable for acute reperfusion therapy, invasive and non-invasive cardiac investigations. We report a case of a 65-year-old man with atypical chest pain and new onset left bundle branch block on his electrocardiogram (ECG), who was managed without emergency reperfusion therapy, but instead, with observation and subsequent outpatient non-invasive cardiac investigation