📈 Modified Sgarbossa (Smith) Criteria
UseWhen to use: chest-pain / ACS evaluation with LBBB or ventricular pacing.
StrataAny positive criterion raises occlusion-MI concern — correlate with troponin and clinical context.
LimitsWhen not to use: replacing serial ECG/troponin pathways. · Pitfall: mis-identifying concordance. · Not sole cath activation rule.
SourceSmith-modified Sgarbossa ECG criteria
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
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Methodology · worked example, guidelines & full notes
Any of 3 criteria.
When to use
When to use: chest-pain / ACS evaluation with LBBB or ventricular pacing.
How it works
Positive if any: concordant STE ≥1 mm; concordant STD ≥1 mm V1–V3; discordant STE/S ≤ −0.25.
Key points
- Any of 3 criteria.
- More sensitive than original.
- Next: troponin / consult.
References
- Smith-modified Sgarbossa ECG criteria
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Concordant STE ≥1 mm (any lead with positive QRS) | No |
|---|---|
| Concordant STD ≥1 mm in V1–V3 | No |
| Most discordant STE/S ratio (negative) | -0.30 |
| Or mark discordant ratio ≤ −0.25 | Yes (≤ −0.25) |
→Modified SgarbossaPositive
- Concordant STE ≥1：No
- Concordant STD V1–V3：No
- Discordant STE/S ≤ −0.25：Yes
Verification & sources · governance
FAQ
Frequently asked questions
- Does Modified Sgarbossa (Smith) Criteria upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is Modified Sgarbossa (Smith) Criteria calculated in practice? Can you show a worked example?
- Inputs: Concordant STE ≥1 mm (any lead with positive QRS) No, Concordant STD ≥1 mm in V1–V3 No, Most discordant STE/S ratio (negative) -0.30, Or mark discordant ratio ≤ −0.25 Yes (≤ −0.25) → Result: Modified Sgarbossa Positive（Concordant STE ≥1: No, Concordant STD V1–V3: No, Discordant STE/S ≤ −0.25: Yes）