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Is The HEART Score All That?

Rob Orman, MD, Billy Mallon, MD, and Stuart Swadron, MD
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07:36
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No me gusta!

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Compare and contrast HEART score with other risk stratification tools for chest pain.

 

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Ian L., Dr -

Stretch to believe any missed myocardial infarction and death in a intellectually and emotionally capable person can be defended.

Mike W., MD -

Thx Ian, and that has been the prevailing wisdom through the years, but I wonder if a 'zero miss rate' is really good for our patients? My study: Weinstock MB, Weingart S, Orth F, et al. Risk for clinically relevant adverse cardiac events in patients with chest pain at hospital admission. JAMA Intern Med. 2015;175(7):1207-1212 found the rate of Clinically relevant adverse cardiac events (CRACE) was around 1/2000 but the James study in Journal of Patient safety found a risk of potential mortality from admission 1/160. It is an interesting question how we balance the risk of our own medical legal risk with the long term health of the patient... a question we all struggle w at every shift! Regarding the legal risk, there have been some cases I have been expert and feel care was below standard, but then dropped by the plaintiff. It is a tough environment for plaintiffs these days

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Heart Score, PECARN and A Twist of Lyme Full episode audio for MD edition 175:52 min - 83 MB - M4AHippo Urgent Care RAP July 2016 Summary 549 KB - PDF