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Sgarbossa's criteria
From WikEM
(Redirected from Skarbossa's Criteria)
Contents
Background
- Assesses likelihood that patient with chest pain and baseline LBBB has myocardial damage
- Low sensitivity(20%), high specificity (98%)
- Still consider PCI/t-PA for patients with LBBB and "good story" despite not meeting the criteria
Criteria
Original 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
- Least specific of criteria, see Smith's modification
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%[3]
Management
- Discussion with a cardiologist should precede activation of the Cath Lab for any of the Sgarbossa or modified Sgarbossa criteria
See Also
- EBQ:Sgarbossa Criteria Study
- ST-Elevation Myocardial Infarction (STEMI)
- Original Study - Sgarbossa Criteria for MI in LBBB
External Links
- http://lifeinthefastlane.com/ecg-library/basics/sgarbossa/
- http://emcrit.org/podcasts/left-bundle-branch-block/
Video
References
- ↑ Madias JE. The nonspecificity of ST-segment elevation > or =5.0 mm in V1-V3 in the diagnosis of acute myocardial infarction in the presence of ventricular paced rhythm. J Electrocardiol 2004 Apr; 37(2) 135-9.
- ↑ 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
