Sgarbossa's criteria

Background

• Assesses likelihood that pt w/ chest pain and baseline LBBB has myocardial damage (+CK-MB)
• Criteria do NOT need to be found in contiguous leads
• RBBB should NEVER have ST elevation
• Low Sn, High Sp
  • Still consider PCI/t-PA for pts w/ LBBB and "good story" despite not meeting the criteria

Criteria

• ST elevation ≥1 mm in a lead with upward (concordant) QRS complex - 5 points
• ST depression ≥1 mm in lead V1, V2, or V3 - 3 points
• ST elevation ≥5 mm in a lead with downward (discordant) QRS complex - 2 points
• See Media:Sgarbossa.jpg for example of all 3 criteria

Points

• ≥3 points = 98% probability of STEMI

See Also

ST-Elevation Myocardial Infarction (STEMI)

Source

• Sgarbossa, American Heart Journal 2006
• Sgarbossa, NEJM, February, 1996