What is modified sgarbossa?

What is modified sgarbossa?

Smith-Modified Sgarbossa Criteria The modified rule is positive for “STEMI” if there is discordant ST elevation with amplitude > 25% of the depth of the preceding S-wave. Smith-Modified Sgarbossa Criteria: Concordant ST elevation ≥ 1 mm in ≥ 1 lead. Concordant ST depression ≥ 1 mm in ≥ 1 lead of V1-V3.

What is concordant ST elevation?

Three criteria are included in Sgarbossa’s criteria: ST elevation ≥1 mm in a lead with a positive QRS complex (ie: concordance) – 5 points. concordant ST depression ≥1 mm in lead V1, V2, or V3 – 3 points. ST elevation ≥5 mm in a lead with a negative (discordant) QRS complex – 2 points.

What is the J point?

Introduction. The J point denotes the junction of the QRS complex and the ST segment on the electrocardiogram (ECG), marking the end of depolarization and beginning of repolarization.

What is discordant ST elevation?

ST-elevation is “excessively discordant” when the ST-elevation (measured at the J-point) is > 0.25 or 25% the depth of the S-wave. ST-depression is “excessively discordant” when the ST-depression (measured at the J-point) is > 0.3 or 30% the height of the R-wave.

What does concordant mean in ECG?

Concordance exists when all the QRS complexes in the chest leads are either predominantly positive or predominantly negative. Concordance can be either positive or negative. The presence of concordance suggests that the tachycardia has a ventricular origin.

What causes a RBBB?

RBBB is caused by diseases that affect the right bundle branch or the myocardial region, where the right bundle branch is located. Possible causes include trauma, structural changes, infiltrative diseases (eg, sarcoidosis), myocarditis, and myocardial infarction.

What are the Sgarbossa criteria for ventricular paced rhythm?

Positive Sgarbossa criteria in a patient with a ventricular paced rhythm: There is concordant ST depression in V2-5 (= Sgarbossa positive). The morphology in V2-5 is reminiscent of posterior STEMI, with horizontal ST depression and prominent upright T waves.

What ECG shows LBBB with Sgarbossa criteria?

Baseline ECG showed typical LBBB. There is 1mm concordant ST elevation in aVL (= 5 points). Other features on this ECG that are abnormal in the context of LBBB (but not considered “positive” Sgarbossa criteria) are the pathological Q wave in lead I and the concordant ST depression in the inferior leads III and aVF.

What is the Sgarbossa criteria?

Sgarbossa criteria first described by Elena Sgarbossa offers another tool for assessing for ischemic changes in the context of a LBBB or ventricular paced rhythm. Score of 3 or more has a 90% specificity for myocardial infarction.

How accurate are the Sgarbossa criteria for STEMI diagnosis?

There are two small studies showing good specificity of the traditional Sgarbossa criteria, but poor sensitivity. There are 2 case reports (both by me and co-authors, references below) of STEMI diagnosed in paced rhythm by proportionally excessive discordant ST elevation (modified Sgarbossa criteria).