Smith Modified Sgarbossa / Subtle Anterior STEMI Formula

A 4-variable electrocardiographic formula developed by Dr. Stephen Smith (Hennepin County Medical Center) to distinguish subtle anterior STEMI from benign early repolarization (BER) in patients with anterior ST elevation in leads V1–V4 without obvious STEMI criteria. The formula quantifies ECG features to identify LAD occlusion in patients who would otherwise be misdiagnosed as BER and sent home.