Smith-modified Sgarbossa criteria
Detects occlusion MI in left bundle branch block or 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
Discordant ST elevation with ST/S ratio of −0.25 or less (at least 1 mm STE)
Worked calculation
Your values are highlighted.
- Criteria present
When to use
- Suspected ACS with LBBB or ventricular paced rhythm.
Pearls and pitfalls
- Ratio uses ST elevation at the J point divided by the depth of the preceding S wave.
Why use
More sensitive than the original weighted Sgarbossa.
Positive if any criterion is present