1222 - Inclusion Criteria-1222 - Inclusion Criteria

Video Transcription

Thank you for viewing the Chesapanami Registry Case Scenario for December 2022, where we will discuss inclusion criteria.  A 22-year-old female came directly from work to the emergency department on April 21, 2022 at 7.56 a.m. She stated the pain began at work and described it as a bubble.  Chest pressure and pain associated with nausea. Her blood pressure was 135 over 82. The 12-lead ECG revealed sinus tachycardia with a rate of 110, rightward axis, and low  voltage QRS complex in the limb leads. The chest X-ray was unremarkable and D-dimer was negative.  She was discharged home with instructions to follow up with a primary care physician. Our question is, is this patient included in the Chesapanami Registry as a low-risk  chest pain patient type? Number one, no. Or number two, yes. Please take a few moments to review the documentation and the question before making your final determination.  The answer is number one, no. This patient is not included in the Chesapanami Registry as a low-risk chest pain patient type.  Let us review the inclusion criteria document to determine why. Per the inclusion criteria, patients presenting with chest pain, such as pressure, tightness,  burning, squeezing, or indigestion, and that may present with myocardial ischemia, must have an evaluation which includes, at minimum, an ECG and one troponin.  Our patient did not have a troponin drawn. Therefore, she is not included in the Chesapanami Registry. Additionally, the definition of unstable angina and STEMI or STEMI is not met.  Of note, the patient may have undergone subsequent testing but cannot have undergone a PCI during the same episode of care.  Thank you for reviewing the Chesapanami Registry case scenario for December of 2022.

Video Summary

The video discusses a case scenario of a 22-year-old female who presented to the emergency department with chest pain and other symptoms. Despite experiencing certain criteria associated with chest pain, such as discomfort, nausea, and abnormal ECG findings, the patient is determined to be not included in the Chesapanami Registry as a low-risk chest pain patient type. This is because the patient did not have a troponin test done, which is a required evaluation according to the inclusion criteria, and the patient did not meet the definition of unstable angina or STEMI. It is noted that subsequent testing is possible, but a PCI cannot be performed during the same episode of care. No credits were mentioned in the video.

Keywords

chest pain

emergency department

symptoms

Chesapanami Registry

low-risk chest pain