The Sgarbossa criteria score is used to diagnose acute myocardial infarction in patients with prior left bundle branch block.
It is often difficult to identify a myocardial infarction (MI) in patients with existing left bundle branch block (LBBB). Approximately 1 in 200 patients with MI have LBBB. The use of the Sgarbossa criteria is a well-accepted approach for determining which patients with LBBB are having an MI.
A Sgarbossa score of ≥ 3 is 90% specific for MI, but is not sensitive (36% sensitivity). Therefore, a score ≥ 3 should be acted upon, but a lower score cannot be used to rule out MI. Clinicians should maintain a high index of suspicion if the patient’s clinical presentation is consistent with MI.
Graham Walker, MD
Sgarbossa et al developed and validated the Sgarbossa criteria in 1996, based on a set of electrocardiographic criteria for the diagnosis of acute MI in patients with chest pain and LBBB. The Sgarbossa criteria cannot rule out MI in patients with existing LBBB. Smith et al modified the Sgarbossa criteria by adjusting the component of excessively discordant ST-segment elevation (Smith 2012). This modification has been referenced by Dr. Sgarbossa (Cai 2013) and should be included in the Sgarbossa criteria.
Elena Sgarbossa, MD
Marshall Frank, DO, MPH, FACEP; Carson Sanders, BS, NRP, CCEMT-P; Bryan P. Berry, MD, BCEM, FACEP
James Morris, MD, MPH; Douglas L. Robinson, DO, MS; Andrew Schmidt, DO, MPH
January 1, 2021