Medical Criteria – L

Medical Criteria – L

LEFT BUNDLE BRANCH BLOCK (LBBB):

• Complete LBBB
  • QRS duration >120 msec
  • Broad notched R waves in leads V4, and V5, and/or I, aVL
  • Deep broad S waves in leads V1-2
  • Secondary ST-T changes (-ve in leads with broad notched R
  • waves, +ve in V1-2) are usually present
  • LBBB can mask ECG signs of MI
  • LBBB: lead V 1 negative, V6 positive and notched

LEFT ANTERIOR FASCICULAR BLOCK (LAFB):

(Left Anterior Hemiblock)

• Left Axis Deviation (-30º to -90º)
  • Small q and prominent R in leads I and aVL
  • Small r and prominent S in leads II, III, and aVF

LEFT POSTERIOR FASCICULAR BLOCK (LPFB):

(Left Posterior Hemiblock)

• Right Axis Deviation (110º to 180º)
  • Small r and prominent S in leads I and aVL
  • Small q and prominent R in leads II, III, and aVF

LEFT VENTRICULAR HYPERTROPHY (LVH):

• • S in V1 + R in V5 or V6 >35 mm above age 40, (>40 mm for age 31-40, >45 mm for age 21-30)
  • R in aVL >11 mm
  • R in I + S in III >25 mm
• Additional criteria
• • LV strain pattern (Asymmetric ST depression and T wave inversion in leads I, aVL, V4-V6)
  • Left atrial enlargement

N.B. The more criteria present, the more likely LVH is present.

If only one voltage criteria present, it is called minimal voltage criteria for LVH which could be a normal variant

LEFT ATRIAL ENLARGEMENT (LAE):

• Biphasic P wave with the negative terminal component of the P wave in lead V1 ≥1 mm wide and ≥1 mm deep
• P wave >100 msec, could be notched in lead II (“P mitrale”)

LUNG TRANSPLANTATION:

• Criteria for Transplantation
  • lung allocation score based on:
    1. Post-transplant survival measure, and
    2. Waiting list urgency measure
• Transplant benefi­t = post-transplant survival (days) – waitlist survival (days).

LIVER TRANSPLANTATION:

• Criteria for Transplantation
• • Model for End-Stage Liver Disease (MELD): prognostic model to estimate 3 mo survival following trans jugular intrahepatic portosystemic shunt (TIPS) procedure and to prioritize patients awaiting liver transplant; based on creatinine, bilirubin, INR; MELD scores from 6-40 used to prioritize liver allocation

• • Child-Turcotte-Pugh Score: classi­cation system to assess the prognosis and the abdominal surgery peri-operative mortality of chronic liver disease and cirrhosis; patient must have ≥7 points (Class B) for transplant evaluation

LABORATORY VALUES IN EXUDATIVE PLEURAL EFFUSION:

Ann Intern Med 1979; 77:507-513 Chest 1997; 111:970-980.

• If any one of the criteria for exudates is met – it is an exudate

Also read:

1. Criteria in GPNotebook
2. Criteria in NICE
3. Criteria in Statpearls