Prevalence
Clinical
features
Differential
diagnosis
Investigations
Therapy
Prevention
Prognosis
|  | | | Clinical
features |
Use the following clinical prediction rule to help determine admission to coronary care units.
a
Look for the following risk factors:
-
pain worse than prior angina or the same as the pain associated with a prior myocardial infarction
-
systolic blood pressure <110 mmHg
-
crackles above the bases bilaterally
-
ST elevation or Q waves, not known to be old, in two or more leads
-
ST segment or T wave changes, not known to be old, indicative of myocardial
ischaemia
Risk of major complications
|
Group a
|
risk of major complication at 4 days
|
|
suspected MI on ECG or suspected
ischaemia
on ECG and 2 or more risk factors
|
high
|
|
suspected
ischaemia
on ECG and 1 or no risk factor
|
moderate
|
|
one risk factor with no MI or
ischaemia
on ECG
|
low
|
|
no risk factors
|
very low
|
Why?
A clinical prediction rule can help identify patients at risk of having major complications
|
Risk of major complication at 4 days
|
%
(95% CI)
|
NNF
(95% CI)
|
|
suspected MI on ECG or suspected
ischaemia
ECG and 2 or more risk factors a
|
16%
(12% to 20%)
|
6
(5 to
8)
|
|
suspected
ischaemia
on ECG and 1 or no risk factor |
7.8%
(6.0% to 9.6%)
|
13
(11 to
17)
|
|
one risk factor with no MI or
ischaemia |
3.9%
(2.7% to 5.2%)
|
26
(19 to
37)
|
|
no risk factors |
0.58%
(0.29% to 0.87%)
|
170
(110 to
340)
|
|
internal medicine