Cannon et al reported predictors for recognizing a non-Q-wave acute myocardial infarction (AMI). The authors are from Brigham and Women's Hospital in Boston.
Patient selection: acute ischemic syndrome with no Q waves on the ECG
(1) history of prior coronary angioplasty
(2) duration of chest pain in minutes
(3) ST-segment deviation
(4) recent onset of angina
prior coronary angioplasty
duration of chest pain
< 60 minutes
>= 60 minutes
recent onset of angina
total score =
= SUM(points for all 4 parameters)
• minimum score: 0
• maximum score: 4
• The higher the score the greater the risk of a non-Q-wave AMI.
• A patient low risk for non-Q-wave AMI is often diagnosed with unstable angina.
Percent with non-Q-wave AMI
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