Cardiovascular Medicine Book

Coronary Artery Disease

Congestive Heart Failure

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San Francisco Syncope Rule

Aka: San Francisco Syncope Rule, CHESS Criteria
  1. Indications
    1. Syncope Evaluation
      1. Evaluate short-term risk of serious outcome
      2. May reduce Syncope hospitalization rate
  2. Criteria (Mnemonic: CHESS)
    1. Congestive Heart Failure history
    2. Hematocrit <30%
    3. Electrocardiogram abnormal
    4. Shortness of Breath
    5. Systolic Blood Pressure <90 mmHg at triage
  3. Interpretation
    1. Positive: One of criteria above
  4. Efficacy: Risk for short-term serious Syncope outcome (30 day mortality)
    1. Test Sensitivity: 96% (misses 4% of cases)
    2. Test Specificity: 62%
  5. References
    1. Quinn (2004) Ann Emerg Med 43:224-32 [PubMed]

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