Sgarbossa Criteria Calculator

Score ECG findings with the Sgarbossa criteria to identify acute MI in the presence of LBBB or paced rhythm.

Original Sgarbossa Criteria

Select all ECG findings present on the patient's tracing.

Modified Criterion 3 (Smith-Sgarbossa)

Replaces the fixed ≥ 5 mm threshold with a proportional ratio for higher sensitivity.

≤ −0.25 = positive

Leave blank to use original criterion 3 points from the checkbox above.

Result

Select criteria and click Calculate.

Quick Reference

Score Interpretation Specificity
≥ 5High suspicion for acute MI~98%
3–4Moderate suspicion — consider cath lab activation~90%
1–2Low specificity, MI not excluded~52%
0Criteria not met — low but non-zero risk—

Summary

Score ECG findings with the Sgarbossa criteria to identify acute MI in the presence of LBBB or paced rhythm.

How it works

  1. Assess the patient's ECG for each of the three Sgarbossa criteria findings.
  2. Select the checkboxes corresponding to the ST changes observed on the ECG.
  3. The calculator assigns points (5, 3, or 2) per criterion as originally validated.
  4. For the modified criteria, enter the ST/S amplitude ratio if applicable.
  5. Review the total score and the plain-language interpretation provided.
  6. A score ≥ 3 has high specificity for acute MI; clinical context is always required.

Use cases

  • Emergency physicians evaluating LBBB with chest pain for acute STEMI equivalents.
  • Paramedics running prehospital 12-lead ECG on pacemaker-dependent patients.
  • Cardiology fellows learning to apply and interpret Sgarbossa criteria at the bedside.
  • Medical educators demonstrating the difference between original and modified scoring.
  • Quality assurance reviews of missed MI cases in patients with LBBB.
  • Rapid bedside decision support when cath lab activation is being considered.

Frequently Asked Questions

Last updated: 2026-07-24 · Reviewed by Nham Vu