1/ Today's 🧵 is about the #Sgarbossa Criteria and #Concordance vs #Discordance in simple words.
The objective of this post is to clarify any doubts in a simple, graphic and didactic way. #CardioTwitter @ekgdx
2/ The Sgarbossa criteria were initially introduced over two decades ago to enhance the diagnostic precision for MI in the setting of LBBB. This criteria is widely accepted as one of the most valuable tools to assist in the diagnosis of MI when LBBB is present.
Here you can see a classic example with graphic explanations that will facilitate understanding.
3/ The Sgarbossa Criteria were initially introduced in 1996 by @ElenaSgarbossa et al. They used data from the famous GUSTO-1 trial.
Article🔗 nejm.org/doi/10.1056/NE…
4/ Subsequent modifications by other authors have aimed to improve sensitivity.
Modified Sgarbossa Criteria by @smithECGBlog et al. 2012.
Article 🔗 annemergmed.com/article/S0196-…
5/ Barcelona Criteria by Andrea Di Marco et al. 2020.
Article 🔗 ncbi.nlm.nih.gov/pmc/articles/P…
6/ Here an EKG with classic LBBB and no acute MI.
7/ Below are few examples of acute myocardial infarction in the setting of LBBB.
Courtesy of @syamkumarmd
8/ Another sample of acute MI in the setting of LBBB.
Courtesy of ECG Medical Training.
9/ Another sample of acute MI in the setting of LBBB.
Red circle shows concordant ST segment elevation. Courtesy of Dr. Carlos Pineda from ECG Weekly.
10/ Regarding diagnostic accuracy and sensitivity-specificity for each criteria, please consult the references.
🔗 ekgdx.com/references/#Sg…
11/ Who or what is Sgarbossa?
Elena B. Sgarbossa, MD (@ElenaSgarbossa ), is an American cardiologist, author, and medical translator, originally from Argentina. This criteria is widely accepted as one of the most valuable tools to assist in the diagnosis of MI when LBBB is present.
12/ Take this home
✅ Sgarbossa criteria was a game changer.
✅ Subsequent modifications by other authors have aimed to improve sensitivity. You must study all of them.
✅ You can’t rule out an acute myocardial infarction if the criteria are absent.
13/ More info available in the blog of @ekgdx
Read here: ekgdx.com/blog/sgarbossa…
14/ End
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