A 76 year old man with history of recent stroke presented with acute chest pain and his ECG showed ,
It was diagnosed as Anterior STEMI .Since he had co-exciting renal dysfunction also he was not considered for thrombolysis (Primary PCI not feasible !)
IV Heparin bolus followed by infusion was started. Patient had a comfortable night stay. The ECG taken on the morning looked like this.
Do you call this aborted STEMI or a simply an Ischemic RBBB ?
Transient RBBB due to Ischemia in LAD territory(with septal compromise ) is very much possible during ACS. But , it is a rarely discussed entity unlike ischemic LBBB .
We know qRBBB complicating anterior STEMI is much commoner than LBBB , still transient ischemic RBBB in non STEMI setting seems to be uncommon .Is it possible propensity for Ischemic RBBB is different from necrotic RBBB ?
Dr.S.Venkatesan MD 
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