Identifying STEMI in LBBB and ventricular paced rhythms

Question 1

What is modified Sgarbossa criteria used for

Answer 1

-only for pts with known LBBB
-identify ECG features in LBBB/ paced patients experiencing a STEMI
-scoring system, which you would use when presented with a patient with a LBBB or Ventricular Paced Rhythm, in the presence of clinical symptoms of a STEMI

Remember- new/ presumed new LBBB meets pathway 1 criteria so no need to apply MSC criteria

Question 2

Modified Sgarbossa criteria

Answer 2

If meet one of these criteria 91% chance of STEMI
-concordant ST elevation greater than 1mm in leads with a positive QRS complex (eg. +ve QRS with ST elevation)
-concordant ST segment depression (eg. -ve QRS with ST depression) greater than 1mm in V1-V3
-proportionally excessive discordant ST elevation in 1 or more leads (greater than 25% of depth of preceding S wave)