Sgarbossa's Criteria for MI in Left Bundle Branch Block

id

1732

full_title

Sgarbossa's Criteria for MI in Left Bundle Branch Block

short_title

Sgarbossa's Criteria for MI

med_description

Criteria to diagnose acute MI in patients with prior LBBB.

description

The Sgarbossa’s Criteria for MI in Left Bundle Branch Block diagnoses acute MI in patients with prior Left Bundle Branch Block (LBBB).

keywords

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complaint

[ "Chest Pain", "Shortness of Breath", "Weakness" ]

formula

Addition of the assigned points.

evidence

measurements

[]

information

As mentioned, Sgarbossa's criteria not rule out myocardial infarction in patients with pre-existing Left Bundle Branch Block (it is not sufficiently sensitive), but in patients with ≥3 points, it is specific for MI.

Recently, Stephen Smith modified Sgarbossa Criteria looking at excessively discordant ST elevation and changing this slightly. This has been referenced by Dr. Sgarbossa herself (see reference) and should now be included in Sgarbossa criteria.

refrences

{ "Clinical Practice Guidelines": [ { "href": "", "text": "" } ], "Manufacturer Website": [ { "href": "", "text": "" } ], "Original/Primary Reference": [ { "href": "https://www.ncbi.nlm.nih.gov/pubmed/8559200?dopt=Abstract", "text": "Sgarbossa EB, Pinski SL, Barbagelata A, Underwood DA, Gates KB, Topol EJ, Califf RM, Wagner GS. 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. N Engl J Med. 1996 Feb 22;334(8):481-7. Erratum in: N Engl J Med 1996 Apr 4;334(14):931. PubMed PMID: 8559200." } ], "Other References": [ { "href": "https://www.ncbi.nlm.nih.gov/pubmed/24016487", "text": "Cai Q, Mehta N, Sgarbossa EB, Pinski SL, Wagner GS, Califf RM, Barbagelata A. The left bundle-branch block puzzle in the 2013 ST-elevation myocardial infarction guideline: from falsely declaring emergency to denying reperfusion in a high-risk population. Are the Sgarbossa Criteria ready for prime time? Am Heart J. 2013 Sep;166(3):409-13. doi: 10.1016/j.ahj.2013.03.032. Epub 2013 Aug 6. PubMed PMID: 24016487." } ], "Outcomes": [ { "href": "", "text": "" } ], "Validation": [ { "href": "https://www.ncbi.nlm.nih.gov/pubmed/22939607", "text": "Smith SW, Dodd KW, Henry TD, Dvorak DM, Pearce LA. 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. Ann Emerg Med. 2012 Dec;60(6):766-76. doi: 10.1016/j.annemergmed.2012.07.119. Epub 2012 Aug 31. Erratum in: Ann Emerg Med. 2013 Oct;62(4):302. PubMed PMID: 22939607." } ], "Validations": [] }

pearls

It's often difficult to identify an MI for patients with existing left bundle branch blocks (LBBB). About 1 in 200 patients with MI have LBBB. Sgarbossa's is a well accepted approach at determining which LBBB are having an MI.

usecase

reasons

next_advice

A score of 3 or more is 90% specific for MI, but not sensitive (36%). Therefore a positive score should be acted upon, but a lower score can not by itself rule out MI - maintain a high index of suspicion if the presentation is consistent with MI.

next_actions

next_management

diseases

[ "Myocardial Infarction" ]

instructions

published

2022-04-21T20:28:59.393Z

purpose

[ "Diagnosis" ]

search_terms

[ "lbbb", "ekg", "stemi" ]

seo

{ "keywords_en": "Sgarbossa’s Criteria for MI in Left Bundle Branch Block, sgarbossa LBBB, sgarbossa MI, sgarbossa, sgarbossa MI LBBB, sgarbossa STEMI, sgarbossa MI calc, sgarbossa stemi calc, sgarbossa LBB calc, sgarbossa score, sgarbossa criteria, MI calc, stemi calc, stemi risk, MI LBBB risk score, MI LBB risk calc, left bundle branch block calc, left bundle branch block sgarbossa, left bundle branch block MI, left bundle branch block ACS calc, left bundle branch block criteria MI, Sgarbossa ACS, Sgarbossa ACS calc, Sgarbossa ACS criteria", "meta_description_en": "The Sgarbossa’s Criteria for MI in Left Bundle Branch Block diagnoses acute MI in patients with prior Left Bundle Branch Block (LBBB)." }

specialty

[ "Cardiology", "Critical Care", "Emergency Medicine", "Hospitalist Medicine", "Internal Medicine" ]

departments

[ "Cardiac" ]

tags

[]

version_number

1

versions

[]

related

[ { "calcId": 10353, "short_title_en": "Modified Sgarbossa's Criteria for MI", "slug": "modified-sgarbossas-criteria-mi-left-bundle-branch-block" }, { "calcId": 99, "short_title_en": "TIMI Score for STEMI", "slug": "timi-risk-score-stemi" }, { "calcId": 10079, "short_title_en": "Subtle Anterior STEMI (4-Variable)", "slug": "subtle-anterior-stemi-calculator-4-variable" } ]

ismed

false

section

[ "pearlsPitfallsViewed", "nextStepsViewed", "evidenceViewed" ]

cleaned_departments

[ "cardiology" ]

cleaned_use

[]

pub

true