THE USE OF THE HEART SCORE FOR DIFFERENTIATION OF CHEST PAIN IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

During the quarantine, the public health of Ukraine decreased significantly. Constant stress caused by the possibility of СOVID-19 infection risk has caused the flare-up of chronic conditions. At the moment of the epidemics, it is important to differentiate patients with chest pain quickly, while it may hide COVID-19 as well as other pathology. So, it is relevant to use different scales to evaluate risks for diseases at the moment (diagnostics) or in the future (prognosis). Exactly to divide the patients into groups with low, intermediate, and high risk, many evidence-based studies presented the HEART score, as a practical, as well as available tool for any intensive care physician. It is based on the calculation of risk level for Major Adverse Cardiac Event (MACE) for 6 weeks, such as general mortality rate, MI, or coronary revascularization. Aim of the study. To differentiate patients with chest pain that could be potentially infected with COVID-19 and had low, intermediate, and high risk of Major Adverse Cardiac Event (MACE) during 6 weeks, such as general mortality rate, MI, need in coronary revascularization or coronary artery bypass surgery, and death. Materials and methods. We differentiated 50 cases of admissions to the intensive care unit with the symptoms of expressed chest pain of unknown origin. Among patients, there were 5 potentially COVID-19 patients. 20-70-year-old males (average age was 49.02 ± 1.73 years old) prevailed. All patients had been calculated points according to the HEART score (anamnesis, age, risk factors (smoking, obesity, family history, hypercholesterolemia, AH, DM, peripheral arterial disease), data of ECG, troponin І), as well as they were questioned if they had been suffering from a viral infection and about any possible contact with potential COVID-19 patients. Results of the study. While calculating points according to the HEART score, we found 20% of people with low risk of MACE (2.4±0.12 points), 44% with intermediate risk (5.18±0.16 points), and 36% with high risk (7.83±0.26 points). Among 5 potential patients with COVID-19, who had complaints on chest pain and ST elevation on the ECG, got low troponin І levels after performed PCR and confirmed COVID-19 with further hospitalization to an infectious disease hospital. The patients with low MACE risk did not need hospitalization and special examinations. Their chest pain was accompanied with physical and psychoemotional stress, musculoskeletal disorders and dysautonomia. Conclusions. Prediction of results for patients with chest pain or with acute myocardial infarction, who applied for emergency medical care, is performed with the help of the HEART score. A significant number of patients, who have an intermediate or high risk of MACE, have to be hospitalized immediately.