Used to diagnose a myocardial infarction in an ECG with LBBB or ventricular paced rhythm
Score ≥3 90% specific for acute MI but only 36% sensitive.
Low score cannot rule out MI.
Original Criteria: less sensitive in detecting MI
Concordant ST elevation > 1mm in leads with a + QRS complex (+5 points)
Concordant ST depression > 1mm in V1-V3 (+3 points)
Excessively discordant ST elevations > 5mm in leads with a negative QRS complex (+ 2 points)
Modified Criteria: more sensitive in detecting myocardial infarction
Eliminates the point system.
≥ 1 lead with ≥1 mm of concordant ST elevation
≥ 1 lead of V1-V3 with ≥ 1 mm of concordant ST depression
≥ 1 lead anywhere with ≥ 1 mm STE and proportionally excessive discordant STE, as defined by ≥ 25% of the depth of the preceding S-wave