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Sgarbossa criteria

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https://www.readbyqxmd.com/read/28343654/negative-concordant-t-waves-during-paced-ventricular-rhythm-an-honest-enemy-is-better-than-a-false-friend
#1
Irene di Matteo, Pasquale Crea
The ECG diagnosis of myocardial infarction and ischemia in pacemaker patients is often challenging. The three criteria, proposed by Sgarbossa et al. in 1996, useful to suspect myocardial ischaemia in patient with left bundle branch block were demonstrated to be valid also in pacemaker patients. In the last years, concordant negative T waves in patients with ventricular paced rhythm were linked to various expressions of acute myocardial injury. If available, comparison with previous ECG is crucial. Partial persistence of cardiac memory during fusion beats created an anomalous concordance between negative T waves and QRS axis and could induce erroneous suspicions...
March 14, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28185080/wellens-syndrome-can-indicate-high-grade-lad-stenosis-in-case-of-left-bundle-branch-block
#2
Steffen Grautoff
Diagnosing acute myocardial infarction (AMI) in left bundle branch block (LBBB) is challenging. Modified Sgarbossa criteria are known to help detect AMI in LBBB. This is a report about an electrocardiogram (ECG) with Wellens' signs in combination with a pre-existing LBBB. The ECG of a patient with fluctuating chest pain showed very subtle and one day later more obvious Wellens'signs. A left anterior descending artery (LAD) stenosis was diagnosed and successfully treated. Wellens' syndrome can be diagnosed in a case of LBBB and help detect a high-grade LAD stenosis even if modified Sgarbossa criteria are not met...
March 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28114719/-right-bundle-branch-block-left-bundle-branch-block-pace-maker-in-case-of-acute-coronary-syndrome-is-the-ecg-of-any-value
#3
REVIEW
Steffen Grautoff
The 12 lead ECG is difficult to evaluate if there is a persistent right or even left bundle block or a pace maker continually stimulating the right ventricle. Despite these pre-existing or new ECG changes it might still be possible to detect variations which can hint to an ST-elevation myocardial infarction (STEMI). Diagnosing significant ST elevations in a case of right bundle block is not very challenging. If the ECG shows a left bundle block the modified Sgarbossa criteria should be used for evaluation. These criteria can also be used in a pace maker ECG...
January 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27618475/smith-modified-sgarbossa-criteria-and-paced-rhythms-a%C3%A2-case-report
#4
Nana Sefa, Kelly N Sawyer
BACKGROUND: As the incidence of left bundle branch blocks (LBBBs) and paced-rhythms electrocardiograms (ECGs) increase in the aging global population, the need for rapid and accurate diagnosis of ST-elevation myocardial infarction (STEMI) or STEMI equivalents in patients with these rhythms becomes more imperative. The Sgarbossa and Smith-modified Sgarbossa criteria have been documented to enhance the diagnosis of STEMI in the setting of LBBBs. However, there is a growing body of literature that suggests that these criteria can also be applied for the diagnosis of STEMI in patients with paced rhythms...
November 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27539980/bet-2-diagnosing-acute-myocardial-infarction-in-the-presence-of-ventricular-pacing-can-sgarbossa-criteria-help
#5
REVIEW
Arunan Jothieswaran, Richard Body
The Sgarbossa criteria can be used to identify patients who have acute myocardial infarction (AMI) in the presence of left bundle branch block, which obscures the usual changes associated with ST elevation myocardial infarction. Patients with ventricular paced rhythm have ECG changes with similar morphology to left bundle branch block. A short-cut systematic review was carried out to establish whether the Sgarbossa criteria can accurately diagnose AMI in the presence of ventricular paced rhythm. Three studies were directly relevant to the question...
September 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27430208/ecg-evaluation-in-patients-with-pacemaker-and-suspected-acute-coronary-syndrome-which-score-should-we-apply
#6
Pedro Freitas, Miguel Borges Santos, Mariana Faria, Gustavo Rodrigues, Nélson Vale, Rui Campante Teles, Manuel Almeida, Miguel Mendes
BACKGROUND/PURPOSE: In patients with right ventricular pacing, the ECG shows a left bundle branch block (LBBB) pattern. There are several criteria to diagnose ST-elevation myocardial infarction (STEMI) in patients with LBBB. The aim of this study was to validate and compare Sgarbossa's with two new scores - Selvester's and Smith's - in this context. METHODS: We identified pacemaker patients submitted to coronary angiography due to acute coronary syndrome. ECGs were analyzed by 2 blinded cardiologists...
September 2016: Journal of Electrocardiology
https://www.readbyqxmd.com/read/27402134/diagnosis-of-myocardial-infarction-and-ischemia-in-the-setting-of-bundle-branch-block-and-cardiac-pacing
#7
REVIEW
B Herweg, M B Marcus, S S Barold
The diagnosis of myocardial infarction (MI) in the presence of left bundle branch block (LBBB) or during ventricular pacing (VP) is challenging because of inherent changes in the sequence of ventricular depolarization and repolarization associated with both conditions. Although LBBB and right ventricular (RV) pacing may both produce abnormalities in the ECG, it is often possible to diagnose an acute MI (AMI) or an old MI based on selected morphologic changes. Primary ST-segment changes scoring 3 points or greater according to the Sgarbossa criteria are highly predictive of an AMI in patients with LBBB or RV pacing...
September 2016: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/27318856/evaluation-of-t-wave-morphology-in-patients-with-left-bundle-branch-block-and-suspected-acute-coronary-syndrome
#8
H Pendell Meyers, Elias Jaffa, Stephen W Smith, Weiying Drake, Alexander T Limkakeng
BACKGROUND: T-wave morphology in the setting of left bundle branch block (LBBB) has been proposed as an indicator of myocardial ischemia. OBJECTIVES: We sought to identify T-wave morphology findings in patients with LBBB that predict non-ST-segment elevation myocardial infarction (NSTEMI). We hypothesized that two or more contiguous leads with concordant T waves would be predictive of NSTEMI. METHODS: This was a retrospective cohort study performed by chart review in a tertiary care center emergency department...
September 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27091803/sgarbossa-criteria-for-acute-myocardial-infarction
#9
Debraj Das, Brent M McGrath
No abstract text is available yet for this article.
October 18, 2016: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/27041492/comparison-of-the-qrs-complex-st-segment-and-t-wave-among-patients-with-left-bundle-branch-block-with-and-without-acute-myocardial-infarction
#10
Kenneth W Dodd, Kendra D Elm, Stephen W Smith
BACKGROUND: The modified Sgarbossa criteria have been validated as a rule for diagnosis of acute coronary occlusion (ACO) in left bundle branch block (LBBB). However, no analysis has been done on differences in the QRS complex, T-wave, or ST-segment concordance of < 1 mm in the derivation or validation studies. Furthermore, there was no comparison of patients with acute myocardial infarction (AMI) but without ACO (i.e., non-ST-elevation myocardial infarction [non-STEMI]) to patients with ACO or without AMI (no MI)...
July 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27003375/left-bundle-branch-block-chest-pain-and-catheterization-laboratory-activation-an-unavoidable-cascade-reaction
#11
G Ciliberti, M Del Pinto, F Notaristefano, G Zingarini, G Ambrosio, C Cavallini
Identification of acute myocardial infarction (AMI) in the presence of left bundle branch block (LBBB) remains challenging. European guidelines recommend prompt reperfusion therapy in patients with suspected ongoing myocardial ischemia and new or presumably new LBBB, whereas AHA/ACC guidelines state that LBBB should not be considered diagnostic of AMI in isolation. Sgarbossa criteria and their recent modified version with the introduction of ST/S ratio can be helpful in this setting. A clinical-instrumental algorithm to manage suspected AMI in the presence of LBBB has been recently proposed...
July 2016: Journal of Electrocardiology
https://www.readbyqxmd.com/read/26678648/validation-of-the-modified-sgarbossa-criteria-for-acute-coronary-occlusion-in-the-setting-of-left-bundle-branch-block-a-retrospective-case-control-study
#12
H Pendell Meyers, Alexander T Limkakeng, Elias J Jaffa, Anjni Patel, B Jason Theiling, Salim R Rezaie, Todd Stewart, Cassandra Zhuang, Vijaya K Pera, Stephen W Smith
BACKGROUND: The modified Sgarbossa criteria were proposed in a derivation study to be superior to the original criteria for diagnosing acute coronary occlusion (ACO) in left bundle branch block (LBBB). The new rule replaces the third criterion (5 mm of excessively discordant ST elevation [STE]) with a proportion (at least 1 mm STE and STE/S wave ≤-0.25). We sought to validate the modified criteria. METHODS: This retrospective case-control study was performed by chart review in 2 tertiary care center emergency departments (EDs) and 1 regional referral center...
December 2015: American Heart Journal
https://www.readbyqxmd.com/read/26554118/typical-chest-pain-and-precordial-leads-st-elevation-in-patients-with-pacemakers-are-we-always-looking-at-an-acute-myocardial-infarction
#13
M Ostojić, Marina M Ostojić, Tatjana S Potpara, Marija M Polovina, Mladen M Ostojić, Miodrag C Ostojić
INTRODUCTION: Electrocardiographic (ECG) diagnosis of acute myocardial infarction (AMI) in patients with paced rhythm is difficult. Sgarbossa's criteria represent helpful diagnostic ECG tool. CASE REPORT: A 57-year-old female patient with paroxysmal atrial fibrillation and a permanent pacemaker presented in the Emergency Department with prolonged typical chest pain and ECG recording suggestive for AMI. Documented ECG changes correspond to the first Sgarbossa's criterion for AMI in patients with dual pacemakers (ST-segment elevation of 5 mn in the presence of the negative QRS complex)...
September 2015: Vojnosanitetski Pregled. Military-medical and Pharmaceutical Review
https://www.readbyqxmd.com/read/24575640/electrocardiographic-signs-of-acute-myocardial-infarction-in-left-bundle-branch-block
#14
REVIEW
Igor Ivanov, Sonja Bugarski, Jadranka Dejanović, Anastazija Stojsić Milosavljević, Jasna Radisić Bosić, Bojan Vujin
INTRODUCTION: Acute myocardial infarction is characterized by typical chest pain, electrocardiographic changes in terms of lesion and/or myocardial ischemia and increased cardiac enzymes. It is often difficult to make diagnosis in the presence of non-specific chest pain, the short duration of symptoms and electrocardiographic signs of a complete left bundle branch block. LITERATURE REVIEW: Many authors have tried to set the electrocardiographic criteria that can increase the possibility of correct diagnosis of acute myocardial infarction in such situations...
November 2013: Medicinski Pregled
https://www.readbyqxmd.com/read/24016487/the-left-bundle-branch-block-puzzle-in-the-2013-st-elevation-myocardial-infarction-guideline-from-falsely-declaring-emergency-to-denying-reperfusion-in-a-high-risk-population-are-the-sgarbossa-criteria-ready-for-prime-time
#15
Qiangjun Cai, Nilay Mehta, Elena B Sgarbossa, Sergio L Pinski, Galen S Wagner, Robert M Califf, Alejandro Barbagelata
Prompt and accurate identification of ST-elevation myocardial infarction (STEMI) in the presence of left bundle-branch block (LBBB) remains difficult. The 2004 STEMI guideline recommended emergent reperfusion therapy to patients with suspected ischemia and new or presumably new LBBB. These recommendations have led to frequent false catheterization laboratory activation and inappropriate fibrinolytic therapy because most patients with suspected ischemia and new or presumably new LBBB do not have acute coronary artery occlusion on angiography...
September 2013: American Heart Journal
https://www.readbyqxmd.com/read/23948522/new-st-segment-elevation-myocardial-infarction-criteria-for-left-bundle-branch-block-based-on-qrs-area
#16
COMPARATIVE STUDY
Richard E Gregg, Eric D Helfenbein, Saeed Babaeizadeh
BACKGROUND: ECG detection of ST-segment elevation myocardial infarction (STEMI) in the presence of left bundle-branch block (LBBB) is challenging due to ST deviation from the altered conduction. The purpose of this study was to introduce a new algorithm for STEMI detection in LBBB and compare the performance to three existing algorithms. METHODS: Source data of the study group (143 with acute MI and 239 controls) comes from multiple sources. ECGs were selected by computer interpretation of LBBB...
November 2013: Journal of Electrocardiology
https://www.readbyqxmd.com/read/22939607/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
#17
Stephen W Smith, Kenneth W Dodd, Timothy D Henry, David M Dvorak, Lesly A Pearce
STUDY OBJECTIVE: Sgarbossa's rule, proposed for the diagnosis of acute myocardial infarction in the presence of left bundle branch block, has had suboptimal diagnostic utility. We hypothesize that a revised rule, in which the third Sgarbossa component (excessively discordant ST-segment elevation as defined by ≥5 mm of ST-segment elevation in the setting of a negative QRS) is replaced by one defined proportionally by ST-segment elevation to S-wave depth (ST/S ratio), will have better diagnostic utility for ST-segment elevation myocardial infarction (STEMI) equivalent, using documented coronary occlusion on angiography as reference standard...
December 2012: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/22552171/left-bundle-branch-block-without-concordant-st-changes-is-rarely-associated-with-acute-coronary-occlusion
#18
Ross McMahon, Way Siow, Ravinay Bhindi, Soon Y Soo Hoo, Gemma Figtree, Peter S Hansen, Gregory I C Nelson, Helge H Rasmussen, Michael R Ward
BACKGROUND: The Sgarbossa score has been used to identify acute myocardial infarction on ECG in the presence of LBBB but has relied on elevated CK-MB for validation rather than angiographic evidence of vessel occlusion. METHODS: We determined (a) the presence or absence of Sgarbossa criteria with concordant (S-con) or discordant (S-dis) ST changes, (b) the presence of acute coronary occlusion or likely recent occlusion on angiography and (c) the biochemical evidence of myocardial infarction (Troponin T >0...
August 20, 2013: International Journal of Cardiology
https://www.readbyqxmd.com/read/21296327/utility-of-left-bundle-branch-block-as-a-diagnostic-criterion-for-acute-myocardial-infarction
#19
COMPARATIVE STUDY
Sonia Jain, Henry T Ting, Malcolm Bell, Christine M Bjerke, Ryan J Lennon, Bernard J Gersh, Charanjit S Rihal, Abhiram Prasad
The clinical utility of new or "presumably new" left bundle branch block (LBBB) as an electrocardiographic criterion equivalent to ST-segment elevation myocardial infarction in contemporary practice is not well established. The aim of this study was to investigate the hypothesis that new or presumably new LBBB in symptomatic patients frequently leads to an overdiagnosis of acute myocardial infarction (AMI). A retrospective analysis of data from consecutive patients in the Mayo Clinic's ST-segment elevation myocardial infarction network from July 2004 to August 2009 was conducted among 892 patients, 36 (4%) of whom had new LBBB...
April 15, 2011: American Journal of Cardiology
https://www.readbyqxmd.com/read/21180312/sgarbossa-criteria-and-acute-myocardial-infarction
#20
Neha Alang, Jaya Bathina, Mark Kranis, Dimitrios Angelis
Diagnosis of acute ST-elevation myocardial infarction in the presence of left bundle branch block is difficult. present a case of acute myocardial infarction with LBBB diagnosed and treated using the Sgarbossa criteria.
March 2010: Indian Heart Journal
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