The Sgarbossa criteria help to diagnose acute infarction in the presence of a wide QRS (left bundle branch block or ventricular paced rhythm). The original Sgarbossa Criteria have been modified to improve the accuracy.
Modified Sgarbossa Criteria
- ≥ 1 lead with ≥1 mm of concordant ST elevation
- ≥ 1 lead of V1-V3 with ≥ 1 mm of concordant ST depression
- ≥ 1 lead anywhere with ≥ 1 mm STE and proportionally excessive discordant STE, as defined by ≥ 25% of the depth of the preceding S-wave.
See also: ST changes with LBBB
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This ECG is from a man in his 60s who presented with abdominal pain dyspnoea and altered level of consciousness, in shock.
This ECG shows wide complex tachycardia with concordant ST elevation in V4-6, due to LAD occlusion. The rhythm was likely sinus tachycardia with RBBB and then LAFB mid way through the trace.
This ECG is from a man in his 60s who presented with chest pain for several hours on a background of prior coronary artery disease and hypertension.
This ECG shows LBBB with excessively discordant ST elevation in inferior leads with reciprocal changes in I and aVL. The cause was a RCA in-stent restenosis.
This ECG is from an elderly woman who presented with chest pain on a background of a normal angiogram 3 months prior.
This ECG shows ventricular paced rhythm (likely biventricular) with concordant ST depression in III, aVF and V3. There is excessive discordant ST elevation in I and aVL. The cause was an acute left main occlusion due to suspected embolism.