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At the heart of general practice since 1960

Chest pain score ‘rules out coronary cause’

European researchers say they have developed a score that can help GPs accurately rule out coronary heart disease in patients presenting with chest pain.

Researchers looked at the Marburg Heart Score in 844 patients over 35 years presenting with chest pains as the primary or secondary complaint. Participants were excluded if their chest pain was from over a month ago, or if their chest pains were traumatic.

The components of the MHS are age, sex, known clinical vascular disease, a patient who assumes a cardiac origin of pain, pain that worsens with exercise and pain that is not reproducible by palpation.

Each score component is worth one point and a score of three points or over rules out CHD.

An expert panel reviewed each patient to determine whether CHD had been the cause of the chest pain, and their opinion was compared with the MHS.

They found that 270 patients who received an MHS score of three or more were also classified as CHD negative by the expert panel, with only 10 patients falsely classified as CHD negative by the MHS.

Study lead Jorg Haasenritter, a researcher in family medicine at the University of Marburg, Germany, said: ‘While GPs can largely rely on a negative result, they should consider further clinical assessment in patients with positive results, especially those with a score value of three points.'

Br J Gen Pract 2012, online 1 June

http://www.ingentaconnect.com/content/rcgp/bjgp/2012/00000062/00000599/art00034

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