Modified Sgarbossa Negative - MedEd Library

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Triage

LBBB Sgarb Neg ECG FOAM Ken Grauer, Parker Hambright, Jesse McLaren, Pendell Meyers, Steve Smith A man in his 60s with dizziness, nausea, chest pain, and LBBB Dr Smith's ECG Blog

Prehospital

~HyperT LBBB Sgarb Neg ECG FOAM Ken Grauer, Parker Hambright, Jesse McLaren, Pendell Meyers, Steve Smith A man in his 60s with dizziness, nausea, chest pain, and LBBB Dr Smith's ECG Blog

Discharge

Discordant ST -Dynamic Sgarb Neg Serial ECG ECG FOAM Ken Grauer, Jesse McLaren, Pendell Meyers, Steve Smith Chest pain + troponin of 1600 + LBBB + 6mm ST elevation = occlusion MI, right? Dr Smith's ECG Blog

Initial

Resolved Chest Pain Discordant ST LBBB Sgarb Neg ECG FOAM Ken Grauer, Jesse McLaren, Pendell Meyers, Steve Smith Chest pain + troponin of 1600 + LBBB + 6mm ST elevation = occlusion MI, right? Dr Smith's ECG Blog

Initial

HyperT LBBB Sgarb Neg Subtle Inferoposterior MI ECG FOAM Ken Grauer, Steve Smith Which Modified Sgarbossa Rule does this meet? And what is the Rhythm? Dr Smith's ECG Blog

A-V Paced Arrest Fragmented QRS -HyperK Sgarb Neg ECG FOAM Steve Smith Typical chest pain and hypotension, Activate the Cath lab? Dr Smith's ECG Blog

Prehospital

Chest Pain LBBB Sgarb Neg Pathological Q Wave 12-lead ECG FOAM Ken Grauer, Pendell Meyers, Steve Smith A 60-something Woman with Chest Pain and a Wide QRS Dr Smith's ECG Blog

Initial

LBBB LVH Sgarb Neg ECG FOAM Steve Smith A 50-something woman with chest pain, BP 230/120, and LBBB with 7 mm ST Elevation Dr Smith's ECG Blog

Serial

LBBB Sgarb Neg Sinus Tach ECG FOAM Steve Smith Acute chest pain in a patient with cardiomyopathy and a paced rhythm. Dr Smith's ECG Blog

Initial

Sgarb Neg ECG FOAM Steve Smith Following Criteria Exactly, even the Modified Sgarbossa Criteria, Can Be Deadly Dr Smith's ECG Blog

Dilated Cardiomyopathy Excess Disc. STE Sgarb Neg Ventricular Pacing ECG FOAM Steve Smith Patient with Paced Rhythm in Severe Cardiomyopathy Presents with SOB due to Acute Decompensated Heart Failure Dr Smith's ECG Blog

Immediate postop

Sgarb Neg Ventricular Pacing ECG FOAM Steve Smith Hours out of the OR for valve replacement surgery: patient with paced rhythm becomes hemodynamically unstable Dr Smith's ECG Blog

Initial

LBBB Sgarb Neg ECG FOAM Steve Smith Chest Pain, LBBB, and a ratio that does not quite meet the Modified Sgarbossa Criteria Dr Smith's ECG Blog

16min later

Dynamic LAD occlusion LBBB Sgarb Neg ECG FOAM Johanna Moore, Steve Smith A Fascinating Demonstration of ST/S Ratio in LBBB and Resolving LAD Ischemia Dr Smith's ECG Blog

Arrival, pain free

LAD occlusion LBBB Sgarb Neg ECG FOAM Johanna Moore, Steve Smith A Fascinating Demonstration of ST/S Ratio in LBBB and Resolving LAD Ischemia Dr Smith's ECG Blog

15min after pain resolved

LAD occlusion LBBB Sgarb Neg ECG FOAM Johanna Moore, Steve Smith A Fascinating Demonstration of ST/S Ratio in LBBB and Resolving LAD Ischemia Dr Smith's ECG Blog

4h later

Sgarb Neg Serial ECG Ventricular Pacing ECG FOAM Steve Smith Paced rhythm, Modified Sgarbossa negative, but with a Wall Motion abnormality. Dr Smith's ECG Blog

Initial

Sgarb Neg Ventricular Pacing ECG FOAM Steve Smith Paced rhythm, Modified Sgarbossa negative, but with a Wall Motion abnormality. Dr Smith's ECG Blog

Sgarb Neg Ventricular Pacing ECG FOAM Steve Smith Paced rhythm. Is there Ischemic ST elevation? Dr Smith's ECG Blog

Sgarb Neg Ventricular Pacing ECG FOAM Steve Smith Paced rhythm. Is there Ischemic ST elevation? Dr Smith's ECG Blog

Serial

LBBB Sgarb Neg ECG FOAM Steve Smith Acute Severe Pulmonary Edema and New LBBB, with Bedside Echo Dr Smith's ECG Blog

Initial

LBBB Sgarb Neg ECG FOAM Steve Smith Acute Severe Pulmonary Edema and New LBBB, with Bedside Echo Dr Smith's ECG Blog

After fluids

Resolved Excess Disc. STE LBBB Sgarb Neg ECG FOAM Steve Smith Is there excessively discordant ST Elevation in this ECG with Left Bundle Branch Block? Dr Smith's ECG Blog

LBBB Sgarb Neg STE Tachy ECG FOAM Steve Smith Is there excessively discordant ST Elevation in this ECG with Left Bundle Branch Block? Dr Smith's ECG Blog

Bradycardia again

LBBB Sgarb Neg Multi-Vessel Disease Mobitz 2 ECG FOAM Steve Smith A Very Unstable Angina. No STEMI present, but needs the cath lab now. Dr Smith's ECG Blog

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