Template:Sgarbossa Criteria

Original Criteria

Sgarbossa's Original Criteria
  • ≥3 points = 98% probability of STEMI[1]
  • 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[2]

Smith's Modified Sgarbossa 3rd Rule
  • Changes the 3rd rule of original Sgarbossa's Criteria to be ST depression OR elevation discordant with the QRS complex and with 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%
  1. 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
  2. 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