Doukky et al used a simple clinical tool to identify patients with systolic heart failure of uncertain cause who may have significant coronary artery disease (CAD). The authors are from John H. Stroger Jr Hospital of Cook County and Rush University Medical Center in Chicago.
Patient selection: systolic heart failure of unclear etiology
Parameters:
(1) history of diabetes mellitus
(2) ECG chances (Q wave and/or left bundle branch block)
(3) CAD risk factors other than diabetes
CAD risk factors other than diabetes:
(1) male >= 55 years of age OR female >= 65years of age
(2) hypertension
(3) dyslipidemia
(4) tobacco use
|
Parameter |
Finding |
Points |
|
history of diabetes |
no |
0 |
|
|
yes |
1 |
|
ECG changes |
absent |
0 |
|
|
present |
1 |
|
CAD risk factors |
0 or 1 |
0 |
|
|
2 or more |
1 |
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 3
• The higher the score the greater the risk of significant coronary artery disease.
|
Score |
Significant CAD |
Severe CAD |
|
0 |
4% |
0% |
|
1 |
32% |
15% |
|
2 |
39% |
16% |
|
3 |
60% |
48% |
Purpose: To evaluate a patient with systolic heart failure of uncertain cause for risk of significant coronary artery disease using the tool of Doukky et al.
Specialty: Cardiology
Objective: risk factors, severity, prognosis, stage
ICD-10: I20-I25, I50,
