Sgarbossa's criteria

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  • 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


  • 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 below for example of all 3 criteria)
  • 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%.


  • ≥3 points = 98% probability of STEMI



See Also

ST-Elevation Myocardial Infarction (STEMI)

External Links



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