• J Electrocardiol · Jan 2021

    Case Reports

    The use of Smith-modified Sgarbossa criteria to diagnose an extensive anterior acute myocardial infarction in a patient presenting with a left bundle branch block.

    • Josip A Borovac, Ana Orsolic, Dino Miric, and Duska Glavas.
    • Department of Pathophysiology, University of Split School of Medicine (MEFST), Soltanska 2, 21000 Split, Croatia; Institute of Emergency Medicine of Split-Dalmatia County (ZHM SDZ), Spinciceva 1, 21000 Split, Croatia. Electronic address: jborovac@mefst.hr.
    • J Electrocardiol. 2021 Jan 1; 64: 80-84.

    AbstractPatients with LBBB of unknown onset presenting with chest pain can pose a diagnostic challenge in the ED while Smith-Modified-Sgarbossa (SMS) ECG criteria might facilitate AMI diagnosis. We demonstrate a case of a 79-year-old man that presented to the ED with chest pain. Original Sgarbossa criteria were negative for AMI while SMS criteria were applied showing proportionally excessive discordance between ST-segment and preceding S-wave thus fulfilling diagnostic criterion for AMI. The coronary angiogram showed the total occlusion of the culprit left anterior descending artery. In this case, awareness of SMS criteria aided in the early prehospital diagnosis of AMI in the setting of LBBB and impacted the course of treatment.Copyright © 2020 Elsevier Inc. All rights reserved.

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