❤️ Sgarbossa Criteria (MI in LBBB/Paced)
UseInterpret possible STEMI when the baseline ECG is paced or shows LBBB.
SourceSmith SW, et al. Ann Emerg Med 2012 (modified Sgarbossa). doi:10.1016/j.annemergmed.2012.07.119
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
Score ≥ 3 is highly specific but insensitive.
When to use
Interpret possible STEMI when the baseline ECG is paced or shows LBBB.
How it works
Concordant ST elevation ≥ 1 mm (5), concordant ST depression ≥ 1 mm in V1–V3 (3), discordant ST elevation ≥ 5 mm (2). ≥ 3 is specific for MI.
Key points
- Score ≥ 3 is highly specific but insensitive.
- Modified (Smith) criteria use ST/S ratio ≤ −0.25 for sensitivity.
- Correlate with serial ECG and troponin.
References
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 ST elevation ≥ 1 mm | No |
|---|---|
| Concordant ST depression ≥ 1 mm in V1–V3 | No |
| Discordant ST elevation ≥ 5 mm | No |
→Sgarbossa0
- Interpretation：< 3 does not confirm MI — does not exclude it.
- Modified：Modified Sgarbossa (Smith) replaces the 5 mm rule with discordant ST/S ratio ≤ −0.25 for greater sensitivity.
| Concordant ST elevation ≥ 1 mm | Yes (+5) |
|---|---|
| Concordant ST depression ≥ 1 mm in V1–V3 | Yes (+3) |
| Discordant ST elevation ≥ 5 mm | Yes (+2) |
→Sgarbossa10
- Interpretation：≥ 3 is specific for acute MI in LBBB/paced rhythm.
- Modified：Modified Sgarbossa (Smith) replaces the 5 mm rule with discordant ST/S ratio ≤ −0.25 for greater sensitivity.
Verification & sources · governance
FAQ
Frequently asked questions
- What are the limits and cautions when using Sgarbossa Criteria (MI in LBBB/Paced)?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- Does Sgarbossa Criteria (MI in LBBB/Paced) 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 Sgarbossa Criteria (MI in LBBB/Paced) calculated in practice? Can you show a worked example?
- Inputs: Concordant ST elevation ≥ 1 mm No, Concordant ST depression ≥ 1 mm in V1–V3 No, Discordant ST elevation ≥ 5 mm No → Result: Sgarbossa 0（Interpretation: < 3 does not confirm MI — does not exclude it., Modified: Modified Sgarbossa (Smith) replaces the 5 mm rule with discordant ST/S ratio ≤ −0.25 for greater sensitivity.） Inputs: Concordant ST elevation ≥ 1 mm Yes (+5), Concordant ST depression ≥ 1 mm in V1–V3 Yes (+3), Discordant ST elevation ≥ 5 mm Yes (+2) → Result: Sgarbossa 10（Interpretation: ≥ 3 is specific for acute MI in LBBB/paced rhythm., Modified: Modified Sgarbossa (Smith) replaces the 5 mm rule with discordant ST/S ratio ≤ −0.25 for greater sensitivity.）