Sgarbossa's criteria: Difference between revisions

Line 1: Line 1:
==Background==
==Background==
*Assesses likelihood that pt w/ chest pain and baseline LBBB has myocardial damage (+CK-MB)
*Assesses likelihood that pt w/ chest pain and baseline [[LBBB]] has myocardial damage  
**Criteria also applies to LBBB due to paced rhythm
**Criteria also applies to [[LBBB]] due to paced rhythm
*Low Sn, High Sp
*Low sensitivity, high specificity
**Still consider PCI/t-PA for pts w/ LBBB and "good story" despite not meeting the criteria
**Still consider PCI/t-PA for pts w/ LBBB and "good story" despite not meeting the criteria



Revision as of 17:28, 21 April 2014

Background

  • Assesses likelihood that pt w/ chest pain and baseline LBBB has myocardial damage
    • Criteria also applies to LBBB due to paced rhythm
  • Low sensitivity, high specificity
    • 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

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