Sgarbossa's Criteria – New Graphic

Here is a graphic I created to help explain Sgarbossa’s criteria for identifying acute myocardial infarction (AMI) in the presence of left bundle branch block (LBBB) or paced rhythm.

In a previous article I showed this graphic which was created using PowerPoint.

Here is a similar graphic I created this morning by cropping actual ECGs that meet the criteria.


These are the features we should be looking for with LBBB and ventricular paced rhythms!

See also:

80 year old male CC: Chest pain

Excessive discordance as a marker of acute STEMI in LBBB

80 year old male CC: Chest pain – Conclusion

Identifying AMI in the presence of LBBB – Sgarbossa’s Criteria Part I

Identifying AMI in the presence of LBBB – Sgarbossa’s Criteria Part II

“New” LBBB – What’s the big deal?

Discordant ST-segment elevation in LBBB or paced rhythm

Found on the Lifenet Receiving Station (LBBB with concordant ST-depression in leads V3 and V4)

62 year old male CC: Chest pain (LBBB with ST-elevation > 0.2 the QRS complex)

58 year old female CC: Chest pain

58 year old female CC: Chest pain – Conclusion (meets all 3 of Sgarbossa’s criteria)

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EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation
Comments
Justin
Rate Related VS. Primary ST-T Changes:
I'm not sold on true A-Fib, as there is a fusion beat/PAC visible in lead V1, additionally I think that the "U" waves are possibly atrial activity. This pt could be having a fib/ flutter pattern; but its hard to say without slowing down the rate and getting expert consultation from a cardiologist. I Would…
2014-09-22 23:20:29
Billy Bob
Rate Related VS. Primary ST-T Changes:
I think I will have to agree with Michael; I just don't see all that much evidence of WPW; typically with WPW & AF the complexes vary in width and morphology due to the combination of the accessory pathway and normal pathways which I just don't see here. The rate doesn't seem to match what…
2014-09-22 19:02:24
Christopher
59 year old male: chest pressure – Conclusion
I read back over the details on this case and they didn't include whether or not the patient was Left-dominant. Your hunch is probably correct!
2014-09-22 12:55:42
Jonathan
Magnesium and Cardiac Action Potential
I have a background in biochemistry, and so am able to navigate the medical science more than someone without this background. My mom has atrial fibrillation, and so I decided to do some investigation. I am AMAZED to find out how little her primary care doctor knows about Magnesium/Potassium/Calcium concentrations as they pertain to Atrial…
2014-09-22 03:46:58
Jeff
Rate Related VS. Primary ST-T Changes:
He's complaining of 10/10 chest pain that coincided with palpitations with a HR of 206 that is probably A-Fib. I am guessing that if you correct his rate you will allow his myocardium to become perfused again and his chest pain will subside. I would pre-sedate him with Midazolam 2mg and electrically cardiovert starting @…
2014-09-21 19:17:36

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