II. Indications

  1. EKG criteria for diagnosis of acute Myocardial Infarction when Left Bundle Branch Block is present

III. Criteria: Sgarbossa

  1. ST segment elevation of 1 mm or more if in same direction (concordant) as QRS Complex in any lead
    1. Score: 5 Points
  2. ST segment depression of 1 mm or more in any lead from V1 to V3
    1. Score: 3 Points
  3. ST segment elevation of 5 mm or more in opposite direction (discordant) of QRS Complex
    1. Score: 1 Point

IV. Criteria: Modified Sgarbossa (first 2 criteria are the same as with Sgarbossa)

  1. ST segment elevation of 1 mm or more if in same direction (concordant) as QRS Complex in any lead
    1. Score: 5 Points
  2. ST segment depression of 1 mm or more in any lead from V1 to V3
    1. Score: 3 Points
  3. ST segment elevation / S-wave amplitude = -0.25 (modified from original Sgarbossa)
    1. Score: 1 Point
  4. References
    1. Smith (2012) Ann Emerg Med 60(6): 766-76 +PMID:22939607 [PubMed]
    2. Meyers (2015) Am Heart J 170(6): 1255 – 1264 [PubMed]

V. Interpretation

  1. Score of 3 or more suggests acute Myocardial Infarction
  2. Primarily focuses on the concordance of ST and QRS polarity (typically opposite or discordant in normal LBBB)

VI. Efficacy

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