ARIC ALGORITHM TO Classify Cardiac Enzymes as Positive ...
CHS Algorithm to Classify Cardiac Enzymes
as Positive, Borderline, or Normal
| | | |
| |There is no known Cardiac |Muscle Trauma or Cardiac Surgery |
| |Surgery or Muscle Trauma |Exists |
| | | |
|CK-MB ( Upper limit of normal or present |Positive |Normal |
| | | |
|CK-MB ( 10% Total CK, if no upper limit is given |Positive |Normal |
| | | |
|Total CK ( 2x Upper Limit of Normal |Positive |Normal |
|And | | |
|LDH ( 2x Upper Limit of Normal | | |
| | | |
|LDH1: LDH2 ( 1 |Positive |Normal |
| | | |
|LDH1 ( 2x Upper limit of normal if LDH2 is missing |Positive |Normal |
| | | |
|Total CK ( 2x upper limit of normal |Borderline |Normal |
|Or | | |
|LDH ( 2x upper limit of normal | | |
| | | |
|Normal < Total CK < 2x upper limit of normal |Borderline |Normal |
|And | | |
|Normal < LDH < 2x upper limit of normal | | |
| | | |
|5% Total CK < CK-MB < 9% Total CK or “weakly present” |Borderline |Normal |
| | | |
|Normal < CK-MB < 2x upper limit of normal |Borderline |Normal |
| | | |
|Normal < LDH1 < 2x upper limit of normal |Borderline |Normal |
| | | |
|Data present, but insufficient to make at least one of the above tests |Incomplete |Incomplete |
| | | |
|All other results |Normal |Normal |
CHS Diagnostic Criteria for MI
Cardiac Pain Present Cardiac Enzymes
| | | | | |
|ECG Pattern |Abnormal |Equivocal |Incomplete |Normal |
|Evolving Q wave MI or evolving profound ST-T |Definite MI |Definite MI |Definite MI |Probable MI |
|abnormalities (C1-3) | | | | |
|Evolving Q wave evolution (D) or evolving major|Definite MI |Probable MI |No MI |No MI |
|ST-T abnormalities (E,F) or new LBBB (B) | | | | |
|Non-evolving major or minor Q-waves (G) or |Definite MI |No MI |No MI |No MI |
|non-evolving major or minor ST-T abnormalities | | | | |
|(H1-2) | | | | |
|Other ECG, ECG absent or uncodable |No Mi |No MI |No MI |No MI |
Cardiac Pain Absent Cardiac Enzymes
| | | | | |
|ECG Pattern |Abnormal |Equivocal |Incomplete |Normal |
|Evolving Q wave MI or evolving profound ST-T |Definite MI |Definite MI |Definite MI |Definite MI |
|abnormalities (C1-3) | | | | |
|Evolving Q wave evolution (D) or evolving |Definite MI |Definite MI |Probable MI |No MI |
|major ST-T abnormalities (E,F) or new LBBB | | | | |
|(B) | | | | |
|Non-evolving major or minor Q-waves (G) or |Definite MI |Probable MI |No MI |No MI |
|non-evolving major or minor ST-T | | | | |
|abnormalities (H1-2) | | | | |
|Other ECG, ECG absent or uncodable |Definite MI |No MI |No MI |No MI |
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