MDM //

Based on this patients low risk HEART score, with negative troponin and EKG not showing STEMI, patient will be discharged home with outpatient primary care doctor follow up. HEART Score History: Highly suspicious = 2 Moderately suspicious = 1 Slightly or non-suspicious = 0 EKG Significant ST-depression = 2 Nonspecific repolarization disturbance = 1 Normal = 0 Age > or = 65 = 2 > 45-<65 = 1 < or = 45 = 0 Risk factors > or = 3 risk factors or history of atherosclerotic disease = 2 1 or 2 risk factors = 1 No risk factors known = 0 Troponin > 3x normal limit = 2 > 1-<3x normal limit = 1 < normal limit = 0 Low risk score = 0-1, risk of MACE of 1.7% at 6 weeks. Additionally, HEART with 0 and 3hr serial troponin after presentation identified 99% sensitivity for ACUTE CORONARY SYNDROME. "A prospective validation of the HEART score for chest pain patients at the emergency department." B.E. Backus et al. International Journal of Cardiology 168 (2013) 2153-2158



[Back to Main Menu]