A 66-year-old woman with known left bundle branch block presents with 2 hours of chest pain. Which combination of findings constitutes the diagnostic Sgarbossa criterion with the highest specificity for acute myocardial infarction?
- A ST depression of 1 mm in lead V3
- B ST elevation of 1 mm concordant with the QRS complex ✓
- C ST elevation of 2 mm discordant with the QRS complex
- D New Q waves in the lateral leads
Correct answer: B. ST elevation of 1 mm concordant with the QRS complex
Explanation
The original Sgarbossa criteria are concordant ST elevation of at least 1 mm (score 5), concordant ST depression of at least 1 mm in V1-V3 (score 3), and disproportionately excessive discordant ST elevation of at least 5 mm (score 2). Concordant ST elevation has the highest specificity for acute occlusion. Concordant means the ST deviation is in the same direction as the major QRS deflection, which is why option C, being discordant, scores lower.
Reference: Braunwald's Heart Disease, 12th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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