Prehospital T-MACS and HEART scores in the prediction of myocardial infarction: a prospective evaluation

Chest pain suspicious for an acute myocardial infarction (MI) is a common reason for emergency ambulance contact. Most patients have a non-diagnostic ECG and transport to hospital for troponin testing is the rule. In the emergency department, tools such as the troponin-only Manchester acute coronary syndrome (T-MACS) decision aid1 and the HEART (history, ECG, age, risk factors and troponin) score2 are used to identify those at low risk of MI for consideration of early discharge. Recently, the history and ECG-only Manchester acute coronary syndrome (HE-MACS) decision aid3 and the HEAR (history, ECG, age and risk factors) score4 have been developed, aiming to identify low-risk patients without troponin testing. We previously demonstrated the feasibility of paramedics using the HEAR and HEART scores,5 6 but performance did not enable a safe rule out of MI in this setting. Whether...

Source: Emergency Medicine Journal - March 21, 2024 Category: Emergency Medicine Authors: Cooper, J. G., Donaldson, L. A., Coutts, A. J., Body, R., Mills, N. L. Tags: Research letter Source Type: research