The effectiveness of modified heart score in evaluating patient presented with chest pain to Emergency Hospital Universiti Sains Malaysia

• Main Author: Ayob, Muhammad Aslam
• Format: Thesis
• Language: English
• Published: 2018
• Subjects: RC705-779 Diseases of the respiratory system
• Online Access: http://eprints.usm.my/46578/1/Dr.%20Muhammad%20Aslam%20Ayob-24%20pages.pdf; http://eprints.usm.my/46578/

Introduction: Chest pain is one of the most common reasons for patients visit to emergency department. The aim of diagnostic process in chest pain at emergency department is to identify both low risk and high risk patients for acute coronary syndrome. Our study objective is to evaluate the effectiveness of modified HEART score in patients presented with chest pain. Methods: Total of 175 patients presented with chest pain at Emergency Department Hospital Universiti Sains Malaysia (EDHUSM) were evaluated retrospectively. The modified HEART score was calculated using patient’s history, ECG, age, risk factor and CKMB/CK relative index. The endpoint was occurrence of major cardiac event (MACE) in 6 weeks’ time. The efficiency of modified HEART score was compared between low risk and non-low risk group. Result: Out of 175 patients evaluated, 30.9 percent of the patients was low risk (score 0-3) category of modified HEART score. However, 14.8% patients from low risk group developed MACE in 6 weeks’ time. The mean of modified HEART score for MACE in 6 weeks was 6.01 for non-low risk and 4.05 for low risk group and statically significant (p value <0.001). There was also significant association between non-low risk group of modified HEART score and the occurrence of MACE (x2=22.35, p<0.0.001). Conclusion: The modified HEART score can assist clinician with quick and reliable predictor outcome without complicated calculation technique. It is a useful alternative to original HEART score for the center without troponin test. The MHS was reliable to identify patients with non-low risk (score 4-10). On the other hand, the MHS cannot be dependable to risk stratified low risk patient and further testing needed for this group of patient.