Template:Sgarbossa Criteria: Difference between revisions
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====Original Criteria<ref>Sgarbossa E. et al.. "Electrocardiographic diagnosis of evolving acute myocardial infarction in the presence of left bundle-branch block. GUSTO-1 (Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries) Investigators". NEJM. 1996. 334(8):481-7</ref>===== | |||
*≥3 points = 98% probability of [[ST-Elevation Myocardial Infarction (STEMI)|STEMI]] | *≥3 points = 98% probability of [[ST-Elevation Myocardial Infarction (STEMI)|STEMI]] | ||
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====Smith's modification==== | ====Smith's modification==== | ||
[[File:modified-sgarbossa.png|thumbnail|Modified Sgarbossa 3rd Rule]] | |||
*Changes the 3rd rule of original [[EBQ:Sgarbossa Criteria Study|Sgarbossa's 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%<ref>Smith, S. et al. Diagnosis of ST-Elevation Myocardial Infarction in the Presence of Left Bundle Branch Block With the ST-Elevation to S-Wave Ratio in a Modified Sgarbossa Rule. 60(6). 766-776</ref> | *Changes the 3rd rule of original [[EBQ:Sgarbossa Criteria Study|Sgarbossa's 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%<ref>Smith, S. et al. Diagnosis of ST-Elevation Myocardial Infarction in the Presence of Left Bundle Branch Block With the ST-Elevation to S-Wave Ratio in a Modified Sgarbossa Rule. 60(6). 766-776</ref> | ||
;Discussion with a cardiologist should precede activation of the Cath Lab for any of the Sgarbossa or modified Sgarbossa criteria | ;Discussion with a cardiologist should precede activation of the Cath Lab for any of the Sgarbossa or modified Sgarbossa criteria | ||
Revision as of 21:48, 21 April 2014
Original Criteria[1]=
- ≥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
- Changes the 3rd rule of original Sgarbossa's 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%[2]
- Discussion with a cardiologist should precede activation of the Cath Lab for any of the Sgarbossa or modified Sgarbossa criteria
- ↑ Sgarbossa E. et al.. "Electrocardiographic diagnosis of evolving acute myocardial infarction in the presence of left bundle-branch block. GUSTO-1 (Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries) Investigators". NEJM. 1996. 334(8):481-7
- ↑ Smith, S. et al. Diagnosis of ST-Elevation Myocardial Infarction in the Presence of Left Bundle Branch Block With the ST-Elevation to S-Wave Ratio in a Modified Sgarbossa Rule. 60(6). 766-776