Abstract:
Rationale: Diagnosis of ST-segment elevation myocardial infarction in the presence of left bundle branch block (LBBB) is challenging and infarction equivalent. Therefore, the intravenous infusion of a thrombolytic may be a crucial step. Emergent Sgarbosa criteria and their modification are guided by advantageous guide keys. Atrial fibrillation represents the risk of arrhythmia in the presence of a left bundle branch block. Interestingly, the presentation of myocardial infarction with atrial fibrillation and left bundle branch block has a significant impact on both morbidity and mortality of patients. Patient Concerns: A middle-aged, married, heavy-smoking Egyptian male patient was admitted to the intensive care unit with acute chest pain with rapid atrial fibrillation, and left bundle branch block. Diagnosis: Left bundle branch block with atrial fibrillation and inferior Yasser’s criterion (Discrepancy criteria) ST-segment deviations as a new description in suspected acute myocardial infarction. Interventions: Electrocardiography, oxygenation, streptokinase IV infusion, and echocardiography. Outcomes: gradual, dramatic clinical and electrocardiographic improvement, but atrial fibrillation and left bundle branch block had occurred.
Lessons: Yasser’s criterion (Discrepancy criterion) is a new descriptive criterion for atrial fibrillation with aberrancy (atrial fibrillation and left bundle branch block). It is characterized by discrepant inferior ST-segment deviations with ST-elevation in III and aVR leads with ST-depression in II and aVF leads. It is an unknown mechanism. Both inferior infarctions of a single lead and pulmonary embolization are possible associations. It may be interpreted as accompanied by severe specific ischemic myocardial insult. Future wide-research studies for Yasser’s criterion (Discrepancy criterion) for sensitivity and specificity will be recommended.
Biography:
Dr. Yasser Mohammed Hassanain Elsayed is a scientist, critical care physician, cardiologist, and independent researcher at the Ministry of Health in Egypt. He has (160) publicized articles with (36) Innovations. They included (7) "Yasser’s sign", (8) "Yasser’s phenomenon", (1) "Yasser’s modification", (2) "Yasser’s maneuver", (1) “Yasser’s method”, (1) “Yasser’s test”, (8) “Yasser’s syndrome”, (1) "Yasser’s fibrillation", (1) "Yasser’s procedure", (1) Yasser’s ECG palpitations wave, (1) Factitious Yasser's infarction, (1) "Yasser’s criterion", (1) "Yasser's conversions", (1) "Amiodarone off-phenomenon, and (1) "Yasser’s classification". He was an international speaker in (46) Conferences, (8) Keynote speaker, and reviewed (more than 352 articles) for (105) Journals and (2) Conferences. He was an honorable editor for (275) Journals, (16) Conferences OCM, and was an instructor in (15) official and (150) non-official training. He has accepted abstracts in Conferences with no presentation (28). He has (54) COVID-19 publicized articles; He was nominated for big prizes such as the Breakthrough Prize, the Einstein Prize, the Shoman Award, Mostafa Prize, etc. He gained (more than 191) excellence certificates. The most famous articles are: 1. Wavy triple, an electrocardiographic sign (Yasser’s sign). 2. Wavy double Electrocardiographic sign (Yasser’s sign). 3. Graded phenomenon (Yasser’s phenomenon). 4. Connected aircraft squadron electrocardiographic sign (Yasser’s sign). 5. Electrocardiographic Passing phenomenon (Flying phenomenon or Yasser’s phenomenon). 6. Movable weaning off an electrocardiographic phenomenon (Yasser’s phenomenon of hypocalcemia). 7. Yasser’s COVID-19 discrepancy phenomenon. 8. Yasser’s maneuver in the psychogenic coma. 9. Yasser’s modification or oxygen test. 10. Three and one method (Yasser’s method). 11. Yasser's stressor test (Fear and calm test). 12. Triphasic Yasser's stressor syndrome (Fear, calm, and fear syndrome). 13. Right-to-left angina Yasser’s syndrome (Swinging Yasser’s central heart syndrome) or Dancing Yasser’s heart syndrome. 14. Sinusoidal atrial fibrillation (Yasser’s fibrillation). 15. Yasser’s triple discoloration sign. 16. Yasser’s procedure. 17. Yasser's Wenckebach reversal phenomenon. 18. Yasser’s cup of coffee stress syndrome (Single cup of coffee stress syndrome). 19. Yasser’s ECG palpitations wave. 20. Bilobed apical floating heart Yasser’s syndrome. 21. Amiodarone off-phenomenon. 22. Factitious Yasser's infarction. 23. Yasser’s criterion of Inferior ST-Segment Discrepancy Deviations in AF. 24. Yasser's pressure maneuver in Left Facial Palsy with Monopelgia. 25. Retrograde Yasser's Flushing Phenomenon in Left Facial Palsy with Monopelgia. 26. Yasser's conversions. 27. Yasser's coving sign. 28. Yasser's squaring saddling syndrome. 29. Partial modified Yasser's WPW syndrome. 30. Yasser's lateral halo sign. 31. Ephemeral Yasser's scooping ST-segment depression and giant T-wave phenomenon. 32. Yasser's migration sign. 33. Tail apex syndrome. 34. Yasser’s V1-aVR rhythm syndrome. 35. Diagonal biting compressive radiological Yasser’s sign. 36. Yasser’s classification of QRS fragmentation.
