MDCalc

Sgarbossa's Criteria for MI in Left Bundle Branch Block

Criteria to diagnose acute MI in patients with prior LBBB.

Concordant ST elevation > 1mm in leads with a positive QRS complex
Concordant ST depression > 1 mm in V1-V3
Excessively discordant ST elevation (or depression) in leads with a negative QRS
In proportion to the preceding S-wave (or R-wave) as determined by 1) at least 1 mm of ST elevation (or depression) AND 2) an ST/S ratio ≤-0.25

Result:

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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.

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