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

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Comments
Steve Pike
Snapshot Case: What Happened?
Thus is the story with elective electrocution. If it works, it's medicine, if it doesn't, it's murder. Every shock shown was indicated, if you don't count the first one.
2015-05-28 22:49:42
Glenda
Snapshot Case: What Happened?
torsades des pointes! Electrolytes??
2015-05-28 16:56:49
Olivier
Snapshot Case: What Happened?
To support Donovan's analysis, QRS are remarkably thin and eventually consistent with paediatric findings. However, as noted, atrial fibrillation in very young patients are quite rare.
2015-05-28 07:36:54
Donovan
Snapshot Case: What Happened?
Looking back on the dosages, though, it occurs to me: this may be a pediatric patient. If that is the case, then for 50 J to be an appropriate dose for Shock 4 (again, assuming the patient is unstable), they would have to weight 25 kg. If that is the case, then the accidental induction…
2015-05-28 01:46:30
Donovan
Snapshot Case: What Happened?
1) Why convert the first rhythm? (brought up by a couple of commenters) -- As is posted in the initial: "required emergent cardioversion for unstable rapid atrial fibrillation" ... rate is not the determining factor about stability, the presence or absence of signs of shock are (hypotension, acutely altered mental status, ischemic chest pain, usw).…
2015-05-28 01:27:57

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