Investigations - cardiac

Question 1

What risk scores can be used for chest pain?

Answer 1

TIMI
GRACE

Question 2

What score in a TIMI is considered high risk of mortality?

Answer 2

Over 4

Question 3

Write down as many of the factors considered in a TIMI

Answer 3

-Age over 65
-aspirin use past 7 days
->3 factors cornary disease (FHx, HPTN, alcohol XS, DM, smokes)
-Known CAD
-Dynamic ECG changes - ST >0.5mm
->2 episodes pain past 24 hours
-Initial Toponin T >14

Question 4

What is the GRACE score used for?

Answer 4

Risk stratifies patients once diagnosis confirmed to determine mortality risk eg higher risk = PCI.

Question 5

What is a TIMI used for?

Answer 5

Estimates % risk at 14 days of: all-cause mortality, new or recurrent MI, or severe recurrent ischemia requiring urgent revascularization in patients post catheterised STEMI

Question 6

What can GRACE be used for that TIMI cant?

Answer 6

GRACE can be used for all ACS while TIMI can only be used for UA/NSTEMI

Question 7

Write as many factors as can for GRACE score

Answer 7

Age
HR/pulse
Systolic BP
Creatinine
Cardiac arrest at admission
ST segment deviation on ECG
Abnormal caridac enzymes
Killip class

Question 8

What is the killip class?

Answer 8

Classifies MI patients - severity of HF and predicts 30 day mortality

Question 9

What are the 4 killip classes?

Answer 9

1 - No signs of congestion
2 - S3 and basal rales auscultation
3 - Acute pulmonary oedema
4 - cardiogenic shock