Template:Sgarbossa Criteria: Difference between revisions

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====Original Criteria<ref>Sgarbossa E. et al.. "Electrocardiographic diagnosis of evolving acute myocardial infarction in the presence of left bundle-branch block. GUSTO-1 (Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries) Investigators". NEJM. 1996. 334(8):481-7</ref>====
====Original Criteria<ref>Sgarbossa E. et al.. "Electrocardiographic diagnosis of evolving acute myocardial infarction in the presence of left bundle-branch block. GUSTO-1 (Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries) Investigators". NEJM. 1996. 334(8):481-7</ref>====
[[File:Sgarbossa.jpg|thumb|Sgarbossa's Original Criteria]]
*≥3 points = 98% probability of [[ST-Elevation Myocardial Infarction (STEMI)|STEMI]]
*≥3 points = 98% probability of [[ST-Elevation Myocardial Infarction (STEMI)|STEMI]]


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====Smith's modification====
====Smith's modification====
[[File:modified-sgarbossa.png|thumbnail|Modified Sgarbossa 3rd Rule]]
[[File:modified-sgarbossa.png|thumbnail|Smith's Modified Sgarbossa 3rd Rule]]
*Changes the 3rd rule of original [[EBQ:Sgarbossa Criteria Study|Sgarbossa's Criteria]] to be ST depression OR elevation discordant w/ the QRS complex and w/ a magnitude of at least 25% of the QRS increases Sn from 52% to 91% at the expense of reducing Sp from 98% to 90%<ref>Smith, S. et al. Diagnosis of ST-Elevation Myocardial Infarction in the Presence of Left Bundle Branch Block With the ST-Elevation to S-Wave Ratio in a Modified Sgarbossa Rule. 60(6). 766-776</ref>
*Changes the 3rd rule of original [[EBQ:Sgarbossa Criteria Study|Sgarbossa's Criteria]] to be ST depression OR elevation discordant w/ the QRS complex and w/ a magnitude of at least 25% of the QRS increases Sn from 52% to 91% at the expense of reducing Sp from 98% to 90%<ref>Smith, S. et al. Diagnosis of ST-Elevation Myocardial Infarction in the Presence of Left Bundle Branch Block With the ST-Elevation to S-Wave Ratio in a Modified Sgarbossa Rule. 60(6). 766-776</ref>
;Discussion with a cardiologist should precede activation of the Cath Lab for any of the Sgarbossa or modified Sgarbossa criteria

Revision as of 03:51, 28 November 2014

Original Criteria[1]

Sgarbossa's Original Criteria
  • ≥3 points = 98% probability of STEMI
  • ST elevation ≥1 mm in a lead with upward (concordant) QRS complex - 5 points
  • ST depression ≥1 mm in lead V1, V2, or V3 - 3 points
  • ST elevation ≥5 mm in a lead with downward (discordant) QRS complex - 2 points

Smith's modification

Smith's Modified Sgarbossa 3rd Rule
  • Changes the 3rd rule of original Sgarbossa's Criteria to be ST depression OR elevation discordant w/ the QRS complex and w/ a magnitude of at least 25% of the QRS increases Sn from 52% to 91% at the expense of reducing Sp from 98% to 90%[2]
  1. Sgarbossa E. et al.. "Electrocardiographic diagnosis of evolving acute myocardial infarction in the presence of left bundle-branch block. GUSTO-1 (Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries) Investigators". NEJM. 1996. 334(8):481-7
  2. Smith, S. et al. Diagnosis of ST-Elevation Myocardial Infarction in the Presence of Left Bundle Branch Block With the ST-Elevation to S-Wave Ratio in a Modified Sgarbossa Rule. 60(6). 766-776