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
Parameters:
(1) history of prior coronary angioplasty
(2) duration of chest pain in minutes
(3) ST-segment deviation
(4) recent onset of angina
Parameter
Finding
Points
prior coronary angioplasty
no
1
yes
0
duration of chest pain
< 60 minutes
0
>= 60 minutes
1
ST-segment deviation
absent
0
present
1
recent onset of angina
no
0
yes
1
total score =
= SUM(points for all 4 parameters)
Interpretation:
• 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.
Score
Percent with non-Q-wave AMI
0
7%
1
20%
2
24%
3
50%
4
71%
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