Template:Sgarbossa Criteria: Difference between revisions
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====Original Criteria==== | ====Original Criteria==== | ||
[[File:Sgarbossa.jpg|thumb|Sgarbossa's Original Criteria]] | [[File:Sgarbossa.jpg|thumb|Sgarbossa's Original Criteria]] | ||
''≥3 points = 98% probability of [[ST-Elevation Myocardial Infarction (STEMI)|STEMI]]''<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> | |||
*ST elevation ≥1 mm in a lead with upward (concordant) | *ST elevation ≥1 mm in a lead with upward QRS complex (concordant) - 5 points | ||
*ST depression ≥1 mm in lead V1, V2, or V3 - 3 points | *ST depression ≥1 mm in lead V1, V2, or V3 - 3 points | ||
*ST elevation ≥5 mm in a lead with downward (discordant) | *ST elevation ≥5 mm in a lead with downward QRS complex (discordant) - 2 points | ||
====Smith's modification<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>==== | ====Smith's modification<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>==== | ||
[[File:modified-sgarbossa.png|thumbnail|Smith's 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 with the QRS complex and with a magnitude of at least 25% of the QRS | *Changes the 3rd rule of original [[EBQ:Sgarbossa Criteria Study|Sgarbossa's Criteria]] to be ST depression '''OR''' elevation discordant with the QRS complex and with a magnitude of at least 25% of the QRS | ||
**Increases Sn from 52% | **Increases Sn from 52% → 91% at the expense of reducing Sp from 98% → 90% | ||
Latest revision as of 03:08, 9 June 2018
Original Criteria
≥3 points = 98% probability of STEMI[1]
- ST elevation ≥1 mm in a lead with upward QRS complex (concordant) - 5 points
- ST depression ≥1 mm in lead V1, V2, or V3 - 3 points
- ST elevation ≥5 mm in a lead with downward QRS complex (discordant) - 2 points
Smith's modification[2]
- Changes the 3rd rule of original Sgarbossa's Criteria to be ST depression OR elevation discordant with the QRS complex and with a magnitude of at least 25% of the QRS
- Increases Sn from 52% → 91% at the expense of reducing Sp from 98% → 90%
- ↑ 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
- ↑ 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