Amal Mattu’s ECG Case of the Week – November 2, 2015

HPI: A 65-year-old male with PMHx of CAD and LBBB presents to the ED with substernal chest pressure and pain that radiates to the both arms. Pain is worse with exertion, and associated with diaphoresis & vomiting. The following ECG is obtained:

Case ECG

Before watching this week’s video, ask yourself these questions:

  1. Should all patients with LBBB who present with ischemic chest pain go to the cath lab emergently?
  2. Would you activate the cath lab based on this HPI and ECG?


Case Interpretation

Review Key Teaching Points



Mattu Class I Indications



Mattu Class IIa Indications



Mattu Class IIB Indications – Stay tuned for next week’s post! 

Kudos: Big thanks to Drs. Bill Brady, Nicolas Pineda, & Erik Klotz for sharing this week’s cases!

Notes: Questions for Amal? Email him at or find him on Twitter @amalmattu.

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