Abstract
BACKGROUND: The Sgarbossa criteria were designed to diagnose ST-segment elevation myocardial infarction in patients who are ventricularly paced or have left bundle branch block. CASE SUMMARY: We report the case of a 74-year-old man who presented with chest pain. The patient had an acute myocardial infarction per the Sgarbossa criteria, but diagnosis was delayed because of the presence of ventricular pacing. Because of this error, intervention was delayed, and the patient eventually developed cardiogenic shock. DISCUSSION: Even though the Sgarbossa criteria are well established, they are often overlooked, which may result in significant morbidity or mortality. This case emphasizes the importance of using the Sgarbossa criteria to evaluate patients in appropriate populations.