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Pulmonary Embolism
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    Calc Function

  • Calcs that help predict probability of a diseaseDiagnosis
  • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
  • Disease is diagnosed: prognosticate to guide treatmentPrognosis
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ADAPT Protocol for Cardiac Event Risk

Assesses chest pain patients at 2-hours for risk of cardiac event.

TIMI Score
Note: Since the TIMI Score includes cardiac enzyme and ST deviation, these are not listed below since they are already included above.

Advice

Barring other concerning features for acute coronary syndrome or other life-threatening causes of chest pain (pneumothorax, pulmonary embolism, cardiac tamponade, aortic dissection, esophageal rupture, etc.), patients that meet the low-risk criteria can be considered for discharge with close follow-up with their primary care physician after negative 0h and 2h troponin testing.

Patients who do not meet the low-risk criteria should be ruled-out for myocardial infarction with serial EKGs and biomarkers and risk stratified as per normal chest pain guidelines and protocols.

Management

  • For low-risk patients: consider other causes of chest pain due to aortic, esophageal, pulmonary, cardiac, and abdominal, and musculoskeletal sources prior to discharge.
  • For non-low-risk patients: Treat as per usual chest pain protocols, including but not limited to consideration of aspirin, nitroglycerin, and serial EKGs and biomarkers at minimum.