II. Indications

  1. Intermittent Chest Pain in outpatients
    1. Evaluate likelihood based on history alone, whether Chest Pain represents coronary cause

III. Criteria

  1. Score 1: Age >= 65 years in women, >=55 years in men
  2. Score 1: Known clinical vascular disease (e.g. CAD, Cerebrovascular Disease)
  3. Score 1: Chest Pain increases with Exercise
  4. Score 1: Chest Pain not reproduced with palpation of the chest wall
  5. Score 1: Patient assumes pain is of cardiac etiology

IV. Interpretation

  1. Background
    1. Based on CAD Pretest Probability in Chest Pain Presentation
  2. Total Score: 0 to 1 (Likelihood Ratio 0.04)
    1. CAD Population Risk 2%: Post-test Risk 0.1%
    2. CAD Population Risk 10%: Post-test Risk 0.4%
    3. CAD Population Risk 20%: Post-test Risk 0.9%
  3. Total Score: 2 to 3 (Likelihood Ratio 0.92)
    1. CAD Population Risk 2%: Post-test Risk 1.8%
    2. CAD Population Risk 10%: Post-test Risk 9.3%
    3. CAD Population Risk 20%: Post-test Risk 18.8%
  4. Total Score: 4 to 5 (Likelihood Ratio 11.2)
    1. CAD Population Risk 2%: Post-test Risk 18.6%
    2. CAD Population Risk 10%: Post-test Risk 55.5%
    3. CAD Population Risk 20%: Post-test Risk 73.7%

V. References

  1. Haesenritter (2012) Br J Gen Pract 62(599):e415-21

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