Cardiovascular Medicine Book

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Troponin-Only Manchester Acute Coronary Syndrome Decision Aid

Aka: Troponin-Only Manchester Acute Coronary Syndrome Decision Aid, T-Macs
  1. See Also
    1. HEART Score
    2. Emergency Department Assessment of Chest Pain Score (EDACS)
  2. Criteria
    1. EKG Ischemia (E)
      1. Score 0: No
      2. Score 1: Yes
    2. Worsening or Crescendo Angina (A)
      1. Score 0: No
      2. Score 1: Yes
    3. Pain radiation to the right arm or Shoulder (R)
      1. Score 0: No
      2. Score 1: Yes
    4. Pain with Vomiting (V)
      1. Score 0: No
      2. Score 1: Yes
    5. Sweating observed (S)
      1. Score 0: No
      2. Score 1: Yes
    6. Hypotension (H)
      1. Score 0: No
      2. Score 1: Yes
    7. Troponin (hs-cTnT) level on arrival (T)
      1. Use hs-cTnT level
  3. Interpretation
    1. Factors (sum these)
      1. E * 1.713
      2. A * 0.847
      3. R * 0.607
      4. V * 1.417
      5. S * 2.085
      6. H * 1.208
      7. T * 0.089
    2. Calculation
      1. Probability = 1/1+e^-FactorSum
      2. Result is the predicted probability for short-term adverse cardiac outcome (<1% is considered low risk)
  4. Efficacy
    1. Test Sensitivity 98-99%
  5. References
    1. Body (2017) Emerg Med J 34(6): 349-56 [PubMed]

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