Identifying STEMI in the presence of LBBB – Sgarbossa’s Criteria Part 2

This series has been updated and moved.

Making Sense of Sgarbossa’s Criteria – Chest Pain and Left Bundle Branch Block – Part 1

Making Sense of Sgarbossa’s Criteria – Chest Pain and Left Bundle Branch Block – Part 2

Making Sense of Sgarbossa’s Criteria – Chest Pain and Left Bundle Branch Block – Part 3

1 Comment

  • SpankyMedic says:

    Hi Tom,

    I absolutely love your educational style, I’ve learned a lot from you…and I have a solid background in cardiovascular health! Anyway, I need clarification. When describing the content in the illustration labeled “Scarbossa’s Criteria” (2nd from last), you write

    “The first example shows > 1 mm of concordant ST segment elevation (and a concordant T wave). Both are abnormal for LBBB.”

    The QRS illustrated is indicative of RBBB.

    My next concern is the following quote:

    “If you have a patient with signs and symptoms consistent with ACS and the ECG shows LBBB with concordant ST segment elevation, then chances are excellent that you are dealing with a STEMI.”

    Assuming that we’re looking at lead V1, I thought that LBBB will show a negatively-deflected QRS? If this is the case, how can there be “concordant” ST elevation?

    These will probably be cleared up easily, but I had to ask. The terms “dis/concordant” are new to me, so I want to make sure I understand them. If possible, could you email your response to this? I don’t always have time to check the website out, but I do check email regularly.

    Thank you again for your excellent commentary! I look forward to reading more of your contributions, and look forward to increasing my cardiovascular knowledge. EXCELLENT JOB!!!

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