Acute Coronary Syndrome (ACS) - Risk Score Tools: Difference between revisions
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== DIAGNOSTIC TOOLS == | == DIAGNOSTIC TOOLS == | ||
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: MD-Calc: | : [https://www.mdcalc.com/sgarbossas-criteria-mi-left-bundle-branch-block '''Sgarbossa's Criteria'''] (MD-Calc) | ||
:: Criteria to diagnose acute MI in patients with prior LBBB. | |||
::: ''It's often difficult to identify an MI for patients with existing left bundle branch blocks (LBBB). About 1 in 200 patients with MI have LBBB. Sgarbossa's is a well accepted approach at determining which LBBB are having an MI.'' | |||
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: [https://www.mdcalc.com/history-electrocardiogram-manchester-acute-coronary-syndromes-macs '''HE-MACS'''] (MD-Calc) (''History and Electrocardiogram-only Manchester Acute Coronary Syndromes'') | |||
:: Stratifies ACS risk with history and EKG only (not yet externally validated). | |||
::: ''INSTRUCTIONS: Use in patients ≥18 years old presenting with suspected cardiac chest pain (symptoms within the last 24 hours)''. | |||
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: [https://www.mdcalc.com/troponin-manchester-acute-coronary-syndromes-t-macs-decision-aid '''T-MACS'''] (MD-Calc) (''Troponin-only Manchester Acute Coronary Syndromes Decision Aid'') | |||
:: Rules out acute coronary syndrome. | |||
::: ''WHEN TO USE: Patients with chest pain that may be cardiac in nature.'' | |||
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: [https://www.mdcalc.com/aortic-dissection-detection-risk-score-add-rs '''ADD-RS'''] (Aortic Dissection Detection Risk Score) | |||
:: Rules out aortic dissection | |||
::: ''IMPORTANT: ADD-RS + D-dimer (the ADvISED study algorithm) has not been externally validated in ruling out acute aortic dissection and should thus be used with caution. The ADD-RS itself is validated.'' | |||
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== PROGNOSTIC TOOLS == | == PROGNOSTIC TOOLS == | ||
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: [https://www.mdcalc.com/timi-risk-index '''TIMI Risk Index'''] (MD-Calc) | |||
::Provides mortality estimate in patients with ACS using only blood pressure, heart rate, and age. | |||
:::''A simple calculator to predict 30-day mortality, which has been well validated against a registry of 150,000 STEMI patients, and shown to have a very good discriminatory capacity. It was also validated against a registry of over 300,000 NSTEMI patients. It has been shown to both predict in-hospital and long-term mortality.'' | |||
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: [https://www.mdcalc.com/timi-risk-score-ua-nstemi '''TIMI Risk Score for UA/NSTEMI'''] (MD-Calc) | |||
::Estimates mortality for patients with unstable angina and non-ST elevation MI. | |||
:::''Can be used to help risk stratify patients with presumed ischemic chest pain. However, it was originally derived in patients with confirmed unstable angina or non-ST elevation myocardial infarction.'' | |||
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: [https://www.mdcalc.com/heart-score-major-cardiac-events '''HEART Score for Major Cardiac Events'''] (MD-Calc) | |||
:: Predicts 6-week risk of major adverse cardiac event. | |||
::: ''INSTRUCTIONS: Use in patients ≥21 years old presenting with symptoms suggestive of ACS. Do not use if new ST-segment elevation ≥1 mm or other new EKG changes, hypotension, life expectancy less than 1 year, or noncardiac medical/surgical/psychiatric illness determined by the provider to require admission.'' | |||
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: [https://www.mdcalc.com/killip-classification-heart-failure '''Killip Classification'''] for Heart Failure (MD-Calc) | |||
:: Quantifies severity of heart failure in ACS and predicts 30-day mortality. | |||
::: ''WHEN TO USE: Patients with confirmed acute coronary syndrome.'' | |||
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[[Acute Coronary Syndrome|Acute Coronary Syndrome Wiki Supplement Page]] |
Latest revision as of 04:09, 21 November 2020
DIAGNOSTIC TOOLS
- Sgarbossa's Criteria (MD-Calc)
- Criteria to diagnose acute MI in patients with prior LBBB.
- It's often difficult to identify an MI for patients with existing left bundle branch blocks (LBBB). About 1 in 200 patients with MI have LBBB. Sgarbossa's is a well accepted approach at determining which LBBB are having an MI.
- Criteria to diagnose acute MI in patients with prior LBBB.
- HE-MACS (MD-Calc) (History and Electrocardiogram-only Manchester Acute Coronary Syndromes)
- Stratifies ACS risk with history and EKG only (not yet externally validated).
- INSTRUCTIONS: Use in patients ≥18 years old presenting with suspected cardiac chest pain (symptoms within the last 24 hours).
- Stratifies ACS risk with history and EKG only (not yet externally validated).
- T-MACS (MD-Calc) (Troponin-only Manchester Acute Coronary Syndromes Decision Aid)
- Rules out acute coronary syndrome.
- WHEN TO USE: Patients with chest pain that may be cardiac in nature.
- Rules out acute coronary syndrome.
- ADD-RS (Aortic Dissection Detection Risk Score)
- Rules out aortic dissection
- IMPORTANT: ADD-RS + D-dimer (the ADvISED study algorithm) has not been externally validated in ruling out acute aortic dissection and should thus be used with caution. The ADD-RS itself is validated.
- Rules out aortic dissection
PROGNOSTIC TOOLS
- TIMI Risk Index (MD-Calc)
- Provides mortality estimate in patients with ACS using only blood pressure, heart rate, and age.
- A simple calculator to predict 30-day mortality, which has been well validated against a registry of 150,000 STEMI patients, and shown to have a very good discriminatory capacity. It was also validated against a registry of over 300,000 NSTEMI patients. It has been shown to both predict in-hospital and long-term mortality.
- Provides mortality estimate in patients with ACS using only blood pressure, heart rate, and age.
- TIMI Risk Score for UA/NSTEMI (MD-Calc)
- Estimates mortality for patients with unstable angina and non-ST elevation MI.
- Can be used to help risk stratify patients with presumed ischemic chest pain. However, it was originally derived in patients with confirmed unstable angina or non-ST elevation myocardial infarction.
- Estimates mortality for patients with unstable angina and non-ST elevation MI.
- HEART Score for Major Cardiac Events (MD-Calc)
- Predicts 6-week risk of major adverse cardiac event.
- INSTRUCTIONS: Use in patients ≥21 years old presenting with symptoms suggestive of ACS. Do not use if new ST-segment elevation ≥1 mm or other new EKG changes, hypotension, life expectancy less than 1 year, or noncardiac medical/surgical/psychiatric illness determined by the provider to require admission.
- Predicts 6-week risk of major adverse cardiac event.
- Killip Classification for Heart Failure (MD-Calc)
- Quantifies severity of heart failure in ACS and predicts 30-day mortality.
- WHEN TO USE: Patients with confirmed acute coronary syndrome.
- Quantifies severity of heart failure in ACS and predicts 30-day mortality.