cliot (version 1.0.0)

modified_sgarbossa_criteria: Modified Sgarbossa Criteria for MI with LBBB

Description

Evaluates the Modified Sgarbossa Criteria to diagnose Acute Myocardial Infarction (AMI) in the presence of Left Bundle Branch Block (LBBB) or Ventricular Paced Rhythm. This modification improves sensitivity over the original criteria by using a proportional ratio (ST/S ratio) for discordant ST elevation rather than an absolute cutoff.

Usage

modified_sgarbossa_criteria(st_elevation_concordant_mm, st_depression_v1_v3_mm,
                            st_elevation_discordant_mm, s_wave_amplitude_mm)

Value

A list containing:

Result

Diagnostic interpretation ("Positive" or "Negative").

Criteria_Met

List of specific criteria satisfied.

Calculated_Ratio

The calculated ST/S ratio.

Arguments

st_elevation_concordant_mm

Numeric. Magnitude of ST elevation (mm) in leads with a positive QRS complex (Concordant STE). (Criterion: >= 1 mm).

st_depression_v1_v3_mm

Numeric. Magnitude of ST depression (mm) in leads V1, V2, or V3 (Concordant STD). (Criterion: >= 1 mm).

st_elevation_discordant_mm

Numeric. Magnitude of ST elevation (mm) in leads with a negative QRS complex (Discordant STE). Used for ratio calculation.

s_wave_amplitude_mm

Numeric. Magnitude (depth) of the S-wave (mm) in the same lead as the discordant STE. Used for ratio calculation.

References

Smith SW, Dodd KW, Henry TD, Dvorak DM, Pearce LA. 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. Ann Emerg Med. 2012;60(6):766-776. doi:10.1016/j.annemergmed.2012.07.119

Examples

# Example 1: Positive (Concordant STE)
# STE Conc 2mm, STD V1-V3 0, STE Disc 0, S-wave 10
modified_sgarbossa_criteria(2, 0, 0, 10)

# Example 2: Positive (Modified Ratio)
# STE Conc 0, STD 0, STE Disc 4mm, S-wave 10mm (Ratio 0.4)
modified_sgarbossa_criteria(0, 0, 4, 10)

# Example 3: Negative
# STE Conc 0, STD 0, STE Disc 2mm, S-wave 20mm (Ratio 0.1)
modified_sgarbossa_criteria(0, 0, 2, 20)