The modified Goldman score and the Triage Rule-out Using high-Sensitivity Troponin accelerated diagnostic protocol (TRUST ADP)
| Modified Goldman risk score | 1 point for each variable present |
|---|---|
| Typical new-onset chest pain at rest | |
| Pain the same as previous myocardial infarction | |
| Pain not relieved by glyceryl trinitrate spray within 15 min | |
| Pain lasting >60 min | |
| Pain occurring with increasing frequency | |
| Hypotension (systolic BP <100 mm Hg) | |
| Acute shortness of breath | |
| Pain within 6 weeks of a myocardial infarction or revascularisation | |
| Modified Goldman total: | |
| TRUST accelerated diagnostic protocol (TRUST ADP) | |
| Low risk* (Suitable for discharge) | 1. Modified Goldman score ≤1 2. Non-ischaemic ECG 3. Presentation high-sensitivity troponin T <14 ng/L |
| Not low risk | 1. Modified Goldman score >1 2. Ischaemic ECG 3. Presentation high-sensitivity troponin T ≥14 ng/L |
*Safety point: protocol not validated in age ≥80 years.