IMR Press / RCM / Volume 22 / Issue 4 / DOI: 10.31083/j.rcm2204144
Open Access Review
Scoring systems for the triage and assessment of short-term cardiovascular risk in patients with acute chest pain
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1 Department of Emergency Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
2 Department of Emergency Medicine, Department of Implementation Science, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
*Correspondence: n.ashburn@wakehealth.edu (Nicklaus P. Ashburn)
Academic Editor: Peter A. McCullough
Rev. Cardiovasc. Med. 2021, 22(4), 1393–1403; https://doi.org/10.31083/j.rcm2204144
Submitted: 7 September 2021 | Revised: 21 October 2021 | Accepted: 21 October 2021 | Published: 22 December 2021
(This article belongs to the Special Issue Evaluation of Chest Pain in the Emergency Department)
Copyright: © 2021 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/).
Abstract

Acute chest pain is a common emergency department (ED) chief complaint. Evaluating patients for acute coronary syndrome is challenging because missing the diagnosis carries substantial morbidity, mortality, and medicolegal consequences. However, over-testing is associated with increased cost, overcrowding, and possible iatrogenic harm. Over the past two decades, multiple risk scoring systems have been developed to help emergency providers evaluate patients with acute chest pain. The ideal risk score balances safety by achieving high sensitivity and negative predictive value for major adverse cardiovascular events while also being effective in identifying a large proportion of patients for early discharge from the ED. This review examines contemporary risk scores used to risk stratify patients with acute chest pain.

Keywords
Risk stratification
Acute coronary syndrome (ACS)
Accelerated diagnostic protocol
Risk scores
Chest pain
Figures
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