Modified Sgarbossa criteria (Smith)
Identifies acute coronary occlusion in left bundle branch block or ventricular paced rhythm.
Inputs
Concordant ST elevation of 1 mm or more in any lead
Concordant ST depression of 1 mm or more in V1, V2, or V3
Excessively discordant ST elevation: ST/S ratio of −0.25 or less (with at least 1 mm STE)
Worked calculation
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- Criteria present
When to use
- Suspected acute MI with LBBB or a ventricular paced rhythm.
Pearls and pitfalls
- Any one criterion is positive (sensitivity about 80%, specificity about 99%).
Why use
Replaces the insensitive original 5 mm discordance criterion.
Positive if any criterion is present