Diamond used a simple clinical classification system for evaluating a patient presenting with chest discomfort. While subjective, the classification system is relevant and easily applied. The author is from Cedars-Sinai Medical Center in Los Angeles.
Parameters:
(1) gender
(2) age
(3) number of symptoms
Symptoms:
(1) Is the discomfort substernal?
(2) Is the discomfort precipitated by exertion?
(3) Is there prompt relief of the discomfort by rest or nitroglycerin?
number of symptoms present =
= SUM(number of "yes" responses)
|
Number of Symptoms Present |
Clinical Classification |
|
0 |
asymptomatic |
|
1 |
nonanginal discomfort |
|
2 |
atypical angina |
|
3 |
typical angina |
Probability of Angiographic Coronary Artery Disease
|
Female - Age in Years |
asymptomatic |
nonanginal discomfort |
atypical angina |
typical angina |
|
35 – 45 |
0.007 +/- 0.006 |
0.027 +/- 0.024 |
0.155 +/- 0.111 |
0.454 +/- 0.186 |
|
45 – 55 |
0.021 +/- 0.018 |
0.069 +/- 0.051 |
0.317 +/- 0.160 |
0.677 +/- 0.167 |
|
55 – 65 |
0.054 +/- 0.042 |
0.127 +/- 0.080 |
0.465 +/- 0.174 |
0.839 +/- 0.108 |
|
65 - 75 |
0.115 +/- 0.078 |
0.171 +/- 0.097 |
0.541 +/- 0.169 |
0.947 +/- 0.055 |
from Table 2, page 575
|
Male - Age in Years |
asymptomatic |
nonanginal discomfort |
atypical angina |
typical angina |
|
35 – 45 |
0.037 +/- 0.024 |
0.105 +/- 0.063 |
0.428 +/- 0.144 |
0.809 +/- 0.104 |
|
45 – 55 |
0.077 +/- 0.024 |
0.206 +/- 0.090 |
0.601 +/- 0.129 |
0.907 +/- 0.049 |
|
55 – 65 |
0.111 +/- 0.024 |
0.282 +/- 0.100 |
0.690 +/- 0.106 |
0.939 +/- 0.029 |
|
65 - 75 |
0.113 +/- 0.050 |
0.282 +/- 0.100 |
0.700 +/- 0.103 |
0.943 +/- 0.026 |
Specialty: Cardiology
ICD-10: ,
