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Smith-Modified Sgarbossa Criteria and Paced Rhythms: A Case Report
1Department of Emergency Medicine, William Beaumont Hospital, Royal Oak, Michigan.
The Journal of Emergency Medicine
|September 13, 2016
Summary
The Smith-modified Sgarbossa criteria can aid in diagnosing ST-elevation myocardial infarction (STEMI) in patients with paced rhythms. Emergency physicians should consider these criteria for timely cardiac catheterization laboratory activation.
Area of Science:
- Cardiology
- Emergency Medicine
Background:
- Increasing incidence of left bundle branch blocks (LBBBs) and paced rhythms in the elderly necessitates improved ST-elevation myocardial infarction (STEMI) diagnosis.
- The Sgarbossa and Smith-modified Sgarbossa criteria are established for STEMI diagnosis in LBBB.
- Emerging evidence suggests applicability of these criteria in paced rhythms.
Observation:
- An 84-year-old male presented with acute respiratory distress.
- Electrocardiogram (ECG) showed findings consistent with positive Smith-modified Sgarbossa criteria.
- STEMI diagnosis was made based on these ECG findings.
Findings:
- The case highlights the potential utility of the Smith-modified Sgarbossa criteria in diagnosing STEMI in patients with paced rhythms.
- While sensitivity and specificity in paced rhythms are not fully established, positive criteria warrant consideration.
Implications:
- Emergency physicians can utilize these criteria to identify potential STEMI in patients with paced rhythms.
- Prompt recognition may lead to appropriate cardiac catheterization laboratory activation.
- This approach can improve outcomes for a challenging patient population.
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