New tool to rule out coronary heart disease in primary care

Jul 05, 2010

A simple new rule can help primary care physicians rule out coronary heart disease in patients with chest pain, states a study published in CMAJ (Canadian Medical Association Journal).

Chest pain is common, yet it is challenging for primary care physicians to reliably identify serious cardiac disease while protecting patients from unnecessary interventions.

The authors developed a clinical decision rule called the Primary Care CHD Score ("Marburg Heart Score") with five predictors that can be easily identified during a patient's visit: age/gender, known clinical vascular disease, pain worse with exercise, patient assumes cardiac origin of pain and pain not reproduced with palpitation.

"The aim of our study was to develop a simple, valid, and usable prediction score based on signs and symptoms to help physicians rule out coronary heart disease (CHD) in patients presenting in ," write Dr. Stefan Bösner, University of Marburg, Marburg, Germany and coauthors.

In a related commentary, Richard Stevens and Daniel Lasserson of University of Oxford, UK, write "the challenge is correctly identifying and referring the patient with while minimizing the number of referrals of patients who do not have CHD, to reduce the harm of unnecessary investigation and burden on healthcare resources." The authors suggest this decision rule shows promise for improving the diagnosis of CHD.

Explore further: Exploring 3-D printing to make organs for transplants

More information: www.cmaj.ca/cgi/doi/10.1503/cmaj.100212

add to favorites email to friend print save as pdf

Related Stories

What is the etiology of cardiac syndrome X?

Dec 01, 2008

Non-cardiac chest pain remains a widespread symptom especially in western countries with a significant economic burden. Patients with chest pain and abnormal electrocardiographic (ECG) but normal coronary angiogram (i.e. ...

Recommended for you

Exploring 3-D printing to make organs for transplants

22 hours ago

Printing whole new organs for transplants sounds like something out of a sci-fi movie, but the real-life budding technology could one day make actual kidneys, livers, hearts and other organs for patients ...

High frequency of potential entrapment gaps in hospital beds

Jul 30, 2014

A survey of beds within a large teaching hospital in Ireland has shown than many of them did not comply with dimensional standards put in place to minimise the risk of entrapment. The report, published online in the journal ...

Key element of CPR missing from guidelines

Jul 29, 2014

Removing the head tilt/chin lift component of rescue breaths from the latest cardiopulmonary resuscitation (CPR) guidelines could be a mistake, according to Queen's University professor Anthony Ho.

Burnout impacts transplant surgeons (w/ Video)

Jul 28, 2014

Despite saving thousands of lives yearly, nearly half of organ transplant surgeons report a low sense of personal accomplishment and 40% feel emotionally exhausted, according to a new national study on transplant surgeon ...

User comments : 0