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Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
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Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
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Effectiveness of Modified HEART Score in Predicting Major Adverse Cardiac Events.

Sultan Tuna Akgol Gur1, Meryem Betos Kocak2, Abdullah Osman Kocak1

  • 1Department of Emergency Medicine, Ataturk University School of Medicine, Erzurum, Turkey.

The Eurasian Journal of Medicine
|March 15, 2021
PubMed
Summary

The modified HEART (mHEART) score, incorporating visual analog scale (VAS) pain severity, better identifies patients at low risk for major adverse cardiac events (MACE) than the standard HEART score. This improves chest pain assessment in emergency settings.

Keywords:
Heart scoreacute coronary syndromechest pain

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Area of Science:

  • Emergency Medicine
  • Cardiology
  • Clinical Decision Support

Background:

  • Chest pain is a common emergency department presentation requiring accurate risk stratification.
  • Existing scoring systems, like the HEART score, aid in decision-making but can be improved.
  • Visual analog scale (VAS) for pain severity is a readily available patient-reported outcome.

Purpose of the Study:

  • To modify the HEART score by incorporating the VAS pain severity.
  • To evaluate the performance of the modified HEART (mHEART) score in predicting major adverse cardiac events (MACE).

Main Methods:

  • Retrospective analysis of 293 patients presenting with chest pain.
  • Calculation of HEART score and a modified HEART (mHEART) score, adding a point for VAS ≥7.
  • Comparison of mHEART and HEART scores for predicting MACE within 30 days.

Main Results:

  • The mHEART score demonstrated improved predictive accuracy compared to the HEART score.
  • Fewer patients incorrectly classified as low-risk for MACE using the mHEART score (1/246) versus the HEART score (6/251).
  • 26.3% of patients had VAS scores ≥7, indicating significant pain severity in a notable subgroup.

Conclusions:

  • Incorporating VAS pain severity into the HEART score enhances its ability to identify low-risk chest pain patients.
  • The mHEART score offers a more refined tool for emergency physicians managing chest pain presentations.
  • Further validation studies are recommended to support the clinical adoption of the mHEART score.