Sgarbossa criteria
Also calledSgarbossa's criteria · modified Sgarbossa criteria · Smith-modified Sgarbossa criteria · Sgarbossa score
Definition
A three-part scoring rule for diagnosing acute MI in the presence of left bundle branch block, based on ST deviation that breaks the expected discordant pattern; the same criteria have also been tested in ventricular paced rhythm. The components are: ST elevation of at least 1 mm concordant with the QRS complex (5 points), ST depression of at least 1 mm in V1, V2 or V3 (3 points), and ST elevation of at least 5 mm discordant with the QRS complex (2 points); in the original study a total of at least 3 points gave 90 percent specificity for infarction. The Smith-modified rule keeps the first two components but replaces the fixed 5 mm rule with proportionally excessive discordant ST elevation: at least 1 mm of discordant ST elevation that is at least 25 percent of the depth of the preceding S wave (ST/S ratio of -0.25 or less). The modified rule is unweighted (any one positive criterion counts) and was more sensitive than the original.
Sources
- Sgarbossa EB, Pinski SL, Barbagelata A, et al. Electrocardiographic diagnosis of evolving acute myocardial infarction in the presence of left bundle-branch block. N Engl J Med. 1996;334(8):481-487. doi.org/10.1056/NEJM199602223340801
- Maloy KR, Bhat R, Davis J, Reed K, Morrissey R. Sgarbossa criteria are highly specific for acute myocardial infarction with pacemakers. West J Emerg Med. 2010;11(4):354-357. pubmed.ncbi.nlm.nih.gov/21079708/
- Smith SW, Dodd KW, Henry TD, et al. Diagnosis of ST-elevation myocardial infarction in the presence of left bundle branch block with the ST-elevation to S-wave ratio in a modified Sgarbossa rule. Ann Emerg Med. 2012;60(6):766-776. doi.org/10.1016/j.annemergmed.2012.07.119
Last reviewed 2 October 2026. Every definition in the EKG Dictionary cites the guideline, consensus statement or original paper it comes from.