AHA Chest pain 2021 guidelines Flashcards
How soon should ECG have to be done when patient presenting to ER for chest pain?
10 minutes
Name 3 reasons to favour CCTA in acute chest pain as an alternative to stress imaging?
- Rule out obstructive CAD (vs ischemia guided management)
- Detect non obstructive CAD
- Age < 65
Name 7 contraindications to vasodilators MPI
- 2nd/3rd degree HB
- Asthma
- SBP < 90mmhg
- Sinus brady < 45 bpm
- VT
- Recent use of Dipyrimadole
- Use of methylxanthines/caffeine
How frequent should high sensitivity troponins be measured? normal sensitivity?
- 1 and 3 hours
- 3 and 6 hours
What constitutes low risk when patients presents to ER with chest pain? (%)
< 1%
What risk of patients is TTE recommended for chest pain assessment?
Intermediate risk
When is cath recommneded for intermediate risk patients?
When NIV testing in ER or 1 year prior shows moderate to severe ischemia
Review the Acute chest pain with IR risk algorithm
Review the acute chest pain with IR risk and known CAD algorithm
What 6 criteria for high risk for acute ER presentation?
- New LV dysfunction
- Moderate to severe ischemia on stress testing
- hemodynamic instability
- high risk on CDP
- Troponin elevation
- ECG changes
What is recommended for high risk patients?
ICA
Review the stable chest pain with no known CAD algorithm
Review the algorithm for stable chest pain + known CAD
What are 5 factors that increase CMD?
Diabetes
Hypertension
LVH
Small coronary vessel size
Infiltrative heart disease
What Index of microcirculatory restriction (IMR) and coronary flow reserve is needed for CMD dx during a ACh bolus
- IMR > 25
- CFR < 2.0
- With angina, ST depression
