ECGs

Question 1

What are the modified Sgarbossa criteria?

Answer 1

Concordant STElevation of > 1mm any lead
Concordant ST Depression of > 1 mm V1-V3
Discordant ST/S ratio > 0.25

More sensitive but less specific than original Sgarbossa

Question 2

Original Sgarbossa criteria?

Answer 2

Concordant STElevation of > 1mm any lead
Concordant ST Depression of > 1 mm V1-V3
Discordant ST Elevation > 5mm

If score greater than or equal to 3–>98 % specific but sensitivity as low as 20% in some studies

Question 3

When do you use Sgarbossa?

Answer 3

Evaluate for STEMI in paced rhythm and LBBB rhythm

Question 4

What are ECG STEMI equivalents?

Answer 4

• De Winters T waves
• Sgarbossa Criteria
• Posterior MI
• Wellens syndrome
• Left Main

Question 5

What do De Winters T waves look like?

Answer 5

Symmetrically peaked t waves precordial leads
ST depression > 1mm below j point
upstroke of t wave commences below isoelectric line
STE >0.5mm in AVR

Anterior STEMI mimic

Question 6

What is Wellens A syndrome?

Answer 6

-Biphasic T waves V2 and V3 with a history of chest pain now resolved
-Suggests critical stenosis of LAD

Question 7

What is Wellens B syndrome?

Answer 7

Deeply inverted t waves in V2 and V4 with a history of chest pain now resolved
-Suggestrs critical LAD stenosis