Sgarbossa Criteria for Evaluating EKG in Setting of Left Bundle Branch Block

Modified Sgarbossa Criteria

As discussed in this article by Stephen Smith, modified Sgarbossa criteria have been created to improve diagnostic accuracy. The most important change is the modification of the rule for excessive discordance. The use of a 5 mm cutoff for excessive discordance was arbitrary and non-specific — for example, patients with LBBB and large voltages will commonly have ST deviations > 5 mm in the absence of ischaemia.

The modified rule is positive for STEMI if there is discordant ST elevation with amplitude > 25% of the depth of the preceding S-wave.

Modified Sgarbossa Criteria:

  • ≥ 1 lead with ≥1 mm of concordant ST elevation
  • ≥ 1 lead of V1-V3 with ≥ 1 mm of concordant ST depression
  • ≥ 1 lead anywhere with ≥ 1 mm STE and proportionally excessive discordant STE, as defined by ≥ 25% of the depth of the preceding S-wave.

See the modified Sgarbossa criteria in action in this excellent case study by Stephen Smith.

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s