Sgarbossa's criteria: Difference between revisions
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==See Also== | ==See Also== | ||
[[ST-Elevation Myocardial Infarction (STEMI)]] | [[ST-Elevation Myocardial Infarction (STEMI)]] | ||
[[EBQ:Sgarbossa Criteria Study|Original Study - Sgarbossa Criteria for MI in LBBB]] | |||
==External Links== | ==External Links== | ||
Revision as of 17:50, 12 April 2014
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
See Also
ST-Elevation Myocardial Infarction (STEMI) Original Study - Sgarbossa Criteria for MI in LBBB
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