Goldman Criteria for ICU Chest Pain Admission
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EKG Findings:
1. Myocardial infarction suspected on EKG. [comment memo="Criteria not met if changes were present on prior EKG"]
... ST Elevation 1 mm or more or pathologic Q waves in 2 or more leads. ---> [select name="MI" value="no=0|yes=100"]
2. Ischemia suspected on EKG. [comment memo="Criteria not met if changes were present on prior EKG"]
... ST depression of 1 mm or more or T-wave inversion in 2 or more leads. ---> [select name="ischemia" value="no=0|yes=10"]
Risk Factors (1 point for each positive risk factor)
A. Low Systolic Blood Pressure [comment memo="Hypotensive reading at any point during the emergency department stay"]
... Systolic Blood Pressure <100 mmHg ---> [select name="SBP" value="no=0|yes=1"]
B. Congestive Heart Failure signs.
... Rales heard above the bases bilaterally. ---> [select name="CHF" value="no=0|yes=1"]
C. Chest Pain worse than baseline Angina [comment memo="This risk factor is positive if 1 or more is present"]
... Known unstable Ischemic Heart Disease ---> [select name="unstable" value="no=0|yes=.1"]
... New post-infarction Angina ---> [select name="new_angina" value="no=0|yes=.1"]
... Angina after a coronary revascularization procedure ---> [select name="revasc" value="no=0|yes=.1"]
... Pain similar to prior Myocardial Infarction ---> [select name="similar" value="no=0|yes=.1"]
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Interpretation (with risk of major cardiac event in subsequent 30 days): [calc value="score=(similar)+(revasc)+(new_angina)+(unstable)+(CHF)+(SBP)+(ischemia)+(MI); score>11.1?'High Risk (18%)':score>1?'Moderate Risk (7%)':score>0?'Low Risk (<5%)':'Very Low Risk (<1%)'" memo="score interpretation"]

[checkbox memo="References (Hide/Show)" name="footnotes" value=""][conditional field="footnotes" condition="(footnotes).isNot('')"][link memo="Goldman (1996) N Engl J Med 334:1498. " url="http://www.ncbi.nlm.nih.gov/pubmed/8618604"][link memo=">FP Notebook page " url="http://www.fpnotebook.com/cv/exam/GldmnCrtrFrIcChstPnAdmsn.htm"][/conditional]