Difference between revisions of "Sgarbossa's criteria"

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==Criteria==
 
==Criteria==
 +
*≥3 points = 98% probability of [[STEMI]]
 +
 +
 
*ST elevation ≥1 mm in a lead with upward (concordant) QRS complex - 5 points
 
*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 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
 
*ST elevation ≥5 mm in a lead with downward (discordant) QRS complex - 2 points
*(See [[#Example | below]] for example of all 3 criteria)
+
**Smith's modification of 3rd rule of Sgarbossa criteria to be ST depression OR elevation discordant w/ the QRS complex and w/ a magnitude of at least 25% of the QRS increases Sn from 52% to 91% at the expense of reducing Sp from 98% to 90%
 
 
*Smith's modification of the third rule of the Sgarbossa criteria to ST depression or elevation discordant with the QRS complex and with a magnitude of at least 25% of that of the QRS complex increases sensitivity from 52% to 91% at the expense of reducing specificity from 98% to 90%.
 
 
 
==Points==
 
*≥3 points = 98% probability of [[STEMI]]
 
  
==Example==
+
==Example of all 3 criteria==
 
[[File:Sgarbossa.jpg]]
 
[[File:Sgarbossa.jpg]]
  

Revision as of 22:44, 14 October 2013

Background

  • Assesses likelihood that pt w/ chest pain and baseline LBBB has myocardial damage (+CK-MB)
    • Criteria also applies to LBBB due to paced rhythm
  • Low Sn, High Sp
    • Still consider PCI/t-PA for pts w/ LBBB and "good story" despite not meeting the criteria

Criteria

  • ≥3 points = 98% probability of STEMI


  • 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
    • Smith's modification of 3rd rule of Sgarbossa criteria to be ST depression OR elevation discordant w/ the QRS complex and w/ a magnitude of at least 25% of the QRS increases Sn from 52% to 91% at the expense of reducing Sp from 98% to 90%

Example of all 3 criteria

Sgarbossa.jpg

See Also

ST-Elevation Myocardial Infarction (STEMI)

External Links

1. http://lifeinthefastlane.com/ecg-library/basics/sgarbossa/

2. http://emcrit.org/podcasts/left-bundle-branch-block/

Source

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