Sgarbossa’s Criteria for MI in LBBB


Sgarbossa’s Criteria for MI in LBBB
Concordant ST elevation > 1mm in leads with a positive QRS complex
Concordant ST depression > 1 mm in V1-V3
Excessively discordant ST elevation (or depression) in leads with a negative QRS In proportion to the preceding S-wave (or R-wave) as determined by 1) at least 1 mm of ST elevation (or depression) AND 2) an ST/S ratio ≤-0.25

Ladies and Gentlemen, your journey into the heart of cardiology begins here! Ever wanted to decode the enigma of Sgarbossa’s Criteria for Myocardial Infarction in Left Bundle Branch Block (MI in LBBB)? Well, you’re in the right place! This ain’t your grandma’s calculator – it’s your sherlockian magnifying glass to scrutinize the human heart.

The Calculation Formula:

Sgarbossa Score = 3*(Concordant ST elevation >= 1 mm in leads with positive QRS) + 2*(Concordant ST depression >= 1 mm in V1-V3) + 1*(Excessively discordant ST elevation >= 5 mm in leads with negative QRS)

Sgarbossa’s Criteria Categories

Category Description Sgarbossa Score Range
Category 1 Concordant ST elevation 3 points
Category 2 Concordant ST depression 2 points
Category 3 Excessively discordant ST elevation 1 point

Calculation Examples

Name Concordant ST elevation Concordant ST depression Excessively discordant ST elevation Total Sgarbossa Score
John Doe 1 mm 0 mm 5 mm 4 points
Sherlock Holmes 2 mm 1 mm 0 mm 7 points

Calculation Methods

Method Pros Cons Accuracy
Traditional Reliable Complex High
Modern Easier Less reliable Moderate

Evolution of Sgarbossa’s Criteria

Year Development
1996 Original criteria established by Sgarbossa et al.
2000 Modified criteria introduced


  1. Individual variations: Different individuals may have different baseline ECGs.
  2. Equipment variations: Different machines may yield slightly different results.

Alternative Methods

Method Pros Cons
Smith-modified Sgarbossa criteria More accurate in certain situations Less well-studied


  1. What is Sgarbossa’s Criteria? It’s a set of criteria used to diagnose a heart attack (myocardial infarction) in people with a specific type of abnormal heart rhythm (left bundle branch block).
  2. How accurate is the Sgarbossa’s Criteria? When used correctly, it can have a high degree of accuracy, but it does depend on the individual and the equipment used.
  3. Who developed the Sgarbossa’s Criteria? The criteria was developed by a team led by Sgarbossa in 1996.
  4. What are the categories in Sgarbossa’s Criteria? There are three categories: Concordant ST elevation, Concordant ST depression, and Excessively discordant ST elevation.
  5. What are the limitations of Sgarbossa’s Criteria? Individual variations and equipment variations are two main limitations.
  6. Are there alternatives to the Sgarbossa’s Criteria? Yes, one alternative is the Smith-modified Sgarbossa criteria.
  7. Can Sgarbossa’s Criteria diagnose all types of heart attacks? No, it’s specifically used for diagnosing myocardial infarctions in people with left bundle branch block.
  8. How do I calculate the Sgarbossa score? The score is calculated using the provided formula, which takes into account the three categories of the criteria.
  9. What does a higher Sgarbossa score mean? A higher score indicates a higher probability of a myocardial infarction.
  10. Can I calculate the Sgarbossa score at home? While the formula is available, it’s recommended that this be done by healthcare professionals as it requires interpretation of an ECG.


  1. American Heart Association
  2. National Institutes of Health