Sgarbossa Criteria — JoyShine Medical

Sgarbossa & Modified (Smith) Sgarbossa Criteria

Applies original and Smith-modified Sgarbossa ECG criteria to diagnose acute coronary occlusion when LBBB or a paced rhythm masks usual STEMI changes (not RBBB); a positive warrants urgent reperfusion evaluation and a negative does not rule out acute MI.

Rule version

Modified (Smith 2012) — recommended Original (Sgarbossa 1996) Both

Concordant ST elevation ≥ 1 mm in any lead with a positive (upward) QRS

No Yes

Concordant ST depression ≥ 1 mm in any of leads V1, V2, or V3

No Yes

[Original criterion 3] Discordant ST elevation ≥ 5 mm in any lead with a negative (downward) QRS

No Yes

[Modified criterion 3] Worst-lead discordant ST/S ratio (J-point STE ÷ preceding S-wave amplitude, same lead; enter the single most negative value, or 0 if no qualifying discordant lead). Range −2.0 to 2.0.

[Modified criterion 3] Does the worst-ratio lead have discordant ST elevation ≥ 1 mm?

No / not applicable Yes