STEMI Criteria

The ACC, AHA, ESC, and World Heart Federation committee established the following ECG criteria for ST-elevation myocardial infarction (STEMI):

• New ST-segment elevation at the J point in 2 contiguous leads with the cutoff point as greater than 0.1 mV in all leads other than V2 or V3
• In leads V2-V3 the cutoff point is greater than 0.2 mV in men older than 40 years old and greater than 0.25 in men younger than 40 years old, or greater than 0.15 mV in women

Patients with a pre-existing left bundle branch block can be further evaluated using Sgarbossa's criteria:

• ST-segment elevation of 1 mm or more that is concordant with (in the same direction as) the QRS complex
• ST-segment depression of 1 mm or more in lead V1, V2, or V3
• ST-segment elevation of 5 mm or more that is discordant with (in the opposite direction) the QRS complex