Journal Club

Journal Club: The HEART Score for Chest Pain in the ED

Hey everyone,

I’d like to post a short blurb about our upcoming journal club which will be Wed July 9 at 6PM @ Metro Gourmet Brick Oven Pizza.  We will be discussing a bread and butter topic that’s applicable to every EM provider: Chest pain and its risk stratification.  Some of the newest scoring out there is pretty exciting and promising.

We will be discussing the original article, titled Chest Pain in the Emergency Room: value of the HEART Score.  Its a great paper that proposes a simple scoring system which yields some pretty convincing findings and I look forward to discussing it soon.

The second article is a prospective validation of this study that can be seen here.

The third article discusses different existing Risk Scores and their applicability to the chest pain presentation in the ED, and can be found here.

 Some Guiding Questions as you read the articles:

1) Reflect on your standard chest pain workup.  What key elements of the patient encounter do you focus on in terms of history and physical exam?   What key elements did the study identify?

2) What are the ideal features of a CP risk stratification score as it pertains to patients presenting to the ED?

3) What are some of the strengths and weaknesses of the existing scoring systems for chest pain assessment?

4) Do you believe that risk stratification scores are comparable to clinical gestalt?

5) Review the hierarchy of clinical evidence (i.e. case studies vs randomized controlled trials). What types of studies were the two HEART articles and how could they have been better designed?



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