/Sgarbossa Criteria

Sgarbossa Criteria

Diagnose MI in presence of LBBB

Total Score

0

Does NOT meet criteria for acute MI. Further clinical context needed.

02Low
310+High

Disclaimer: The clinical scoring and algorithms on this platform are intended strictly for professional informational purposes. They do not constitute a definitive medical diagnosis, treatment, or clinical decision. The final judgment and responsibility lie with the treating physician.

Yasal Uyarı: Bu platformdaki klinik skorlamalar ve algoritmalar yalnızca sağlık profesyonellerini bilgilendirme amaçlıdır. Herhangi bir kesin tıbbi teşhis, tedavi veya klinik karar yerine geçemez. Nihai karar ve sorumluluk hastayı yatak başında değerlendiren hekime aittir.

Clinical Overview

The Sgarbossa Criteria provide a set of electrocardiographic rules used to identify acute ST-Elevation Myocardial Infarction (STEMI) in patients with a pre-existing Left Bundle Branch Block (LBBB) or a right ventricular paced rhythm, conditions which typically distort normal repolarization and obscure standard STEMI signs.

Clinical Pearl

The original criteria had high specificity but poor sensitivity. The 'Modified Sgarbossa Criteria' (Smith modification) improves sensitivity by altering the third rule: instead of >5 mm absolute discordant ST elevation, it requires a discordant ST elevation to S-wave depth ratio of ≤ -0.25.

Pitfalls & Warnings

  • A score of 0 does NOT rule out a myocardial infarction; clinical suspicion and serial EKGs/troponins remain paramount.
  • Concordant ST depression in V1-V3 is highly specific for posterior STEMI in the setting of LBBB.

Academic References

Sgarbossa EB, Pinski SL, Barbagelata A, et al. Electrocardiographic diagnosis of evolving acute myocardial infarction in the presence of left bundle-branch block. N Engl J Med. 1996;334(8):481-487.

Smith SW, Dodd KW, Henry TD, et al. Diagnosis of ST-elevation myocardial infarction in the presence of left bundle branch block with the ST-elevation to S-wave ratio in a modified Sgarbossa rule. Ann Emerg Med. 2012;60(6):766-776.

Disclaimer: The clinical scoring and algorithms on this platform are intended strictly for professional informational purposes. They do not constitute a definitive medical diagnosis, treatment, or clinical decision. The final judgment and responsibility lie with the treating physician.