Bode-Thomas et al reported a score for myocardial ischemia in a patient with sickle cell anemia. This is particularly useful during a vaso-occlusive crisis. The authors are from the University of Jos, Univresity College Hospital Ibadan, University of Ilorin (Nigeria) and Morehouse School of Medicine in Atlanta.
Patient selection: sickle cell anemia
Parameters:
(1) rhythm
(2) conduction disturbance (PR interval > 160 ms; QRS duration >= 100 ms, sinus pauses with or without escape beats or rhythms)
(3) QTc in milliseconds
(4) QRS-T angle in degrees
(5) number leads show ST segment elevation or depression> 1 mm
(6) number of leads show flat, diphasic or inverted T-waves
Parameter
Finding
Points
rhythm
sinus
0
any non-sinus
1
conduction disturbance
no
0
yes
1
QTc
<= 440 ms
0
> 440 ms
1
QRS-T angle
<= 90 degrees
0
> 90 degrees
1
leads with ST segment changes
none
0
1 or 2
1
3 or 4
2
>= 5
3
leads with T wave changes
none
0
1 or 2
1
3 or 4
2
5 or 6
3
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• The higher the score the greater the risk for and severity of myocardial ischemia.
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