❤️ Sgarbossa Criteria (MI in LBBB/Paced)
Detect acute MI in LBBB or ventricular pacing with the Sgarbossa criteria.
Sgarbossa Criteria (MI in LBBB/Paced)
Concordant ST elevation ≥ 1 mm
Concordant ST depression ≥ 1 mm in V1–V3
Discordant ST elevation ≥ 5 mm
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
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.