Tag Archives: sgarbossa’s criteria

Chest pain, left bundle branch block, and excessively discordant ST-segment elevation

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62 year old male presents to the emergency department complaining of chest discomfort. Past medical history is significant for dyslipidemia and ulcerative colitis. Also prior history of significant tobacco use. Maternal history of CAD. Maternal and paternal history of stroke. The patient’s only medication is Lipitor but he took an aspinin en route to the […]

Discordant ST-Segment Elevation in LBBB or Paced Rhythm

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If you’ve been following the Prehospital 12-Lead ECG blog for a while, you know that I’m advocate of using Sgarbossa’s criteria to help identify acute STEMI in the presence of left bundle branch block (LBBB) or paced rhythm. According the Sgarbossa’s original criteria, 5 mm of discordant ST-segment elevation is required to identify AMI in […]

"New" LBBB – What's the big deal?

In the January 2010 EMCast at EMedHome.com, Amal Mattu MD reviews Chang AM, Shofer FS, Tabas JA, et al. Lack of association between left bundle-branch block and acute myocardial infarction in symptomatic ED patients. Am J Emerg Med 2009;27:916-921. His comments confirm what I have suspected for a long time with regard to LBBB in […]

Sgarbossa's Criteria – New Graphic

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Here is a graphic I created to help explain Sgarbossa’s criteria for identifying acute myocardial infarction (AMI) in the presence of left bundle branch block (LBBB) or paced rhythm. In a previous article I showed this graphic which was created using PowerPoint. Here is a similar graphic I created this morning by cropping actual ECGs […]

94 year old female CC: Chest Pain

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Here is an interesting case submitted by Billy Eskridge. EMS is called to an assisted living facility to evaluate a 94 year old female complaining of chest pain. History of present illness: Approximately 1 hour prior to EMS arrival, the patient had complained of a headache. A nurse gave the patient a Lortab. About 15 […]

Found on the Lifenet Receiving Station

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Is there anything about this ECG (other than the poor data quality) that interests you? The patient was a 90 year old male, fall with injury. Also complaining of pain between the shoulder blades. *** UPDATE *** This ECG caught my eye because it satisfies one of Sgarbossa’s criteria for the identification of AMI in […]

Identifying STEMI in the presence of LBBB – Sgarbossa’s Criteria Part 2

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This series has been updated and moved. Making Sense of Sgarbossa’s Criteria – Chest Pain and Left Bundle Branch Block – Part 1 Making Sense of Sgarbossa’s Criteria – Chest Pain and Left Bundle Branch Block – Part 2 Making Sense of Sgarbossa’s Criteria – Chest Pain and Left Bundle Branch Block – Part 3

Identifying STEMI in the presence of LBBB – Sgarbossa’s Criteria Part 1

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This series has been updated and moved. Making Sense of Sgarbossa’s Criteria – Chest Pain and Left Bundle Branch Block – Part 1 Making Sense of Sgarbossa’s Criteria – Chest Pain and Left Bundle Branch Block – Part 2 Making Sense of Sgarbossa’s Criteria – Chest Pain and Left Bundle Branch Block – Part 3

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