Chest pain - HEART pathway CUH



Algorithm

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Background

Please note the CUH ED HEART pathway is a risk-stratification tool and does not replace sound clinical judgement.


HEART pathway details

HEART History

High risk:

  • Middle or left side
  • Heavy chest pain
  • Sweat / nausea / vomit
  • Exertional
  • Relief with nitrates

Low risk:

  • Well localised
  • Sharp pain
  • Non-exertional
  • No sweating
  • No nausea

HEART ECG

New ischaemic changes = 2 points:

  • Ischaemic ST-segment ↓
  • New ischaemic T inversion

Non-specific changes = 1

  • Repolarization abN
  • Non-specific T changes
  • Non-specific ST - ↓ or ↑
  • BBB
  • LVH
  • Early repolarization
  • Digoxin effect

HEART Risk Factors

  • ↑Cholesterol
  • ↑BP
  • Diabetes
  • Smoking
  • +ve FHx
  • Obesity

Troponin levels CUH

  • Normal ♂: < 34ng/L
  • Normal ♀: < 16ng/L


Content by Dr Íomhar O' Sullivan 11/12/2016. Last review Dr ÍOS 24/08/21.