AEMCA Practice Exam

Which of the following is a contraindication for STEMI bypass?

1. 12-lead shows LBBB

2. Patient is over 60 years old

3. Transport time is less than 30 minutes

4. Patient's history of asthma

The correct answer is: 12-lead shows LBBB

In the context of STEMI (ST-Elevation Myocardial Infarction) bypass, a 12-lead showing left bundle branch block (LBBB) is a significant finding. LBBB can mask the classic signs of a STEMI on an electrocardiogram, which complicates the diagnostic process. When lBBB is present, it may be challenging to accurately identify ST elevation, as the typical patterns associated with a STEMI may not be apparent. Therefore, if LBBB is observed, it could impact decision-making regarding immediate bypass to a facility equipped for reperfusion therapy. In such cases, the potential for misdiagnosis or delayed treatment could arise, making it a contraindication for bypass. The other options relate to factors that do not inherently preclude the necessity for a STEMI bypass. For example, age alone is not a contraindication, as older patients can still experience acute coronary events and benefit from timely intervention. Likewise, a transport time under 30 minutes suggests that rapid transport to a facility may still be feasible and beneficial. Finally, while a history of asthma is important for consideration during treatment, it does not directly impact the decision regarding STEMI bypass protocols.