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    Patent Pending

    Sgarbossa's Criteria for MI in Left Bundle Branch Block

    Criteria to diagnose acute MI in patients with prior LBBB.
    Favorite
    Pearls/Pitfalls

    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.

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    Evidence
    Creator Insights

    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.

    Formula

    Addition of the assigned points.

    Facts & Figures

    As mentioned, Sgarbossa's criteria does 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 references by Dr. Sgarbossa herself (see third reference) and should now be included in Sgarbossa criteria.

    Literature

    Dr. Elena Sgarbossa

    About the Creator

    Elena Sgarbossa, MD, is a board certified cardiologist and works as an independent medical and scientific writer/editor/translator. She is also a member of Editorial Board of the Journal of Electrocardiology. Dr. Sgarbossa previously worked in clinical cardiology and research at Rush-Presbyterian Medical Center and Cleveland Clinic.

    To view Dr. Elena Sgarbossa's publications, visit PubMed