Acute Coronary Syndrome (ACS) - Risk Score Tools: Difference between revisions
From Guide to YKHC Medical Practices
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:: Predicts 6-week risk of major adverse cardiac event. | :: 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.'' | ::: ''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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Revision as of 21:59, 12 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.
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.