Sgarbossa Criteria (Acute MI in LBBB)

KEY POINTS:

--Sgarbossa criteria help look for STEMIs in people with LBBB (left bundle branch block)

ECG CRITERIA:
5 pts - concordant (same direction as QRS complex) ST elevation >=1mm any lead
3 pts - ST depression >=1mm in anterior leads (V1, V2, V3)
2 pts - discordant (opposite direction of QRS) ST elevation >=5mm any lead

--add up the points, score >=3 is 90+ percent specific for an MI
--the discordant ST elevation is apparently less useful

HOW DO I USE THIS?:
--you're handed an EKG, there's a LBBB

--look for >=1mm concordant ST elevation
--look for ST depression in anterior leads

--if you see these things, worry about an MI

Reference(s): THE article, nice website