Sgarbossa’s criteria

Sgarbossa’s criteria

Three criteria are included in Sgarbossa’s criteria:

  1. ST elevation ≥1 mm in a lead with a positive QRS complex (i.e.: concordance) – 5 points
  2. concordant ST depression ≥1 mm in lead V1, V2, or V3 – 3 points
  3. ST elevation ≥5 mm in a lead with a negative (discordant) QRS complex – 2 points

≥3 points = 90% specificity of STEMI (sensitivity of 36%)

Modified Sgarbossa criteria

Modified Sgarbossa criteria were validated in 2015.

  • The sensitivity of the modified criteria increases to 80% without affecting specificity.
  • The third criteria regarding greater than 5 mm of discordance were chosen rather arbitrarily.
  • The modified criteria change 5 mm to greater than 25% of the downward QRS deflection.

Criteria 3 is modified as follows: Discordant ST elevation greater than 25% of downward QRS deflection in a negative QRS complex (2 points)

Smith modified Sgarbossa rule:

  • at least one lead with concordant STE (Sgarbossa criterion 1) or
  • at least one lead of V1-V3 with concordant ST depression (Sgarbossa criterion 2) or
  • proportionally excessively discordant ST elevation in V1-V4, as defined by an ST/S ratio of equal to or more than 0.20 and at least 2 mm of STE. (this replaces Sgarbossa criterion 3 which uses an absolute of 5mm)

Wackers et al. correlated ECG changes in LBBB with localization of the infarct by thallium scintigraphy.[7] The most useful ECG criteria were:

  • Serial ECG changes — 67 percent sensitivity
  • ST segment elevation — 54 percent sensitivity
  • Abnormal Q waves — 31 percent sensitivity
  • Cabrera’s sign — 27 percent sensitivity, 47 percent for anteroseptal MI
  • Initial positivity in V1 with a Q wave in V6 — 20 percent sensitivity but 100 percent specificity for anteroseptal MI

    Subscribe Medicine Question BankWhatsApp Channel

    FREE Updates, MCQs & Questions For Doctors & Medical Students

      Medicine Question Bank
      Enable Notifications OK No thanks