Acute Coronary Syndrome Risk Stratification for Cardiology
Stratify ACS risk using HEART, TIMI, GRACE scores for ED decision-making
What You Can Do
You can systematically evaluate chest pain presentations using evidence-based clinical decision tools (HEART, TIMI, GRACE scores) to categorize patients into risk strata, optimize diagnostic testing sequencing, and guide admission and treatment intensity decisions. This skill helps you reduce unnecessary hospitalizations while ensuring high-risk patients receive timely invasive evaluation and acute therapy.
Features
Rapidly evaluates History, ECG, Age, Risk factors, and Troponin to identify low-risk chest pain patients safe for early discharge
Quantifies short-term (14-day) mortality and ischemic event risk using 7 clinical variables to guide therapeutic intensity
Predicts in-hospital and 6-month mortality risk in confirmed ACS to inform prognosis and intensity of secondary prevention
Systematically applies troponin-negative algorithms and serial biomarker interpretation for safe disposition decisions
Recommends appropriate testing intensity (serial troponin, advanced imaging, stress testing) based on risk stratification results
Clarifies observation unit vs. hospital admission vs. early discharge criteria using validated thresholds
Links risk strata to antiplatelet and anticoagulation dosing and revascularization urgency recommendations
Example Output
Example 1: Low-Risk Chest Pain
- 52-year-old with atypical chest discomfort, normal ECG, negative initial troponin
- HEART Score: 3 (Low Risk)
- Recommendation: Serial troponin at 3 hours; if negative, safe for observation unit or discharge with stress testing within 72 hours; single-dose aspirin; avoid admission
Example 2: Intermediate-Risk ACS
- 68-year-old with typical chest pain, ST depression on ECG, elevated troponin I (0.15)
- TIMI Score: 4 (Intermediate Risk)
- GRACE Score: 125 (Intermediate Mortality Risk)
- Recommendation: Admit to monitored bed; dual antiplatelet therapy + anticoagulation; early invasive strategy (angiography within 24 hours); intensive monitoring
Example 3: High-Risk NSTEMI
- 75-year-old with sustained chest pain, dynamic ST changes, markedly elevated troponin (2.4), prior MI
- GRACE Score: 165 (High Mortality Risk)
- Recommendation: Urgent admission; intensive dual antiplatelet therapy + anticoagulation; expedited angiography (within 2-4 hours); consider mechanical support evaluation
What's Included
- SKILL.md instruction file: Complete clinical algorithm and risk stratification workflows
- HEART Score Calculator Template: Structured worksheet for rapid point-of-care assessment
- Risk Stratification Checklist: Diagnostic and therapeutic decision pathway by risk tier (low/intermediate/high)
- Biomarker Interpretation Guide: Serial troponin algorithms and rule-out ACS protocols
- Therapeutic Intensity Matrix: Evidence-based medication dosing and revascularization timing by risk category
Who It's For
- Emergency Medicine Physicians — Chest pain evaluation and ED disposition decisions
- Cardiologists — Risk assessment in acute coronary care and prognostication
- Hospitalists — Acute care decision-making for admitted chest pain patients
- Nurse Practitioners/Physician Assistants — Chest pain protocols in emergency and acute settings
- Clinical Pharmacists — Antiplatelet and anticoagulation intensity titration based on risk strata
Best For
- Emergency department chest pain evaluation and rule-out ACS protocols
- Triage decisions between observation unit, inpatient admission, and early discharge
- Serial risk reassessment during the first 3–6 hours of presentation
- Matching diagnostic testing intensity (troponin frequency, imaging, stress testing) to risk level
- Guiding therapeutic decisions (dual antiplatelet therapy, anticoagulation dosing, revascularization urgency)
You might also like
You can systematically generate ranked differential diagnoses for presenting complaints (chest pain, dyspnea, abdominal pain, headache, joint pain, fatigue) by applying evidence-based clinical decision rules and risk stratification. The skill helps you identify red flags that change management priority, justify test selection to supervising physicians, and document diagnostic reasoning in the medical record while reducing anchoring bias and ensuring comprehensive consideration of serious diagnoses.
by gptomics
You can rapidly synthesize complex patient data—comorbidities, functional status, labs, medications—into a comprehensive risk profile and actionable optimization plan. This skill guides you through ASA classification, procedure-specific risk stratification, and patient-centered consent documentation to ensure thorough clinical reasoning and defensible preoperative assessment.
by gptomics
This skill guides you through structured psychiatric case formulation using a biopsychosocial framework. You input patient presentation, assessment data, and clinical history, then receive a comprehensive formulation that integrates symptom synthesis, differential diagnosis reasoning, predisposing/precipitating/perpetuating factors, protective factors, and evidence-based treatment recommendations. The output is suitable for clinical documentation, insurance authorizations, case conferences, and supervision.
by gptomics
You can conduct comprehensive subluxation assessments on pediatric patients by integrating structural examination findings, functional limitations, parental observations, and neurological indicators within a developmental context. Claude helps you correlate specific subluxations to presenting complaints (colic, ear infections, torticollis, scoliosis patterns) and create objective documentation suitable for insurance, medical records, and referral purposes. You'll develop age-appropriate treatment plans that address both the subluxation and the child's unique physiological stage.
by gptomics
You synthesize current clinical evidence into structured protocols tailored to your specialty and institutional context. This skill helps you build physician-nurse collaborative decision frameworks, identify implementation barriers before rollout, and create adoption guides that account for resource constraints and stakeholder buy-in. You'll develop protocols ready for medical staff committees and bedside teams—not generic templates, but specialty-specific standards that bridge research and practice.
by gptomics
You can generate complete psychosocial assessment documents that synthesize biographical information, presenting problems, mental health symptoms, social support systems, and environmental stressors into a coherent clinical narrative. The skill structures assessments to meet insurance reimbursement requirements, legal documentation standards, and clinical utility for interdisciplinary treatment planning. Each assessment incorporates the social work perspective of person-in-environment analysis, ensuring clinical decisions account for social, economic, cultural, and relational factors.
by gptomics
You can convert clinical observation notes, standardized assessment results (FIM, COPM, AMPAC, etc.), and patient history into professionally formatted occupational therapy functional assessment reports. The skill synthesizes raw data into cohesive narratives that document baseline function, identify specific functional limitations, justify interventions to insurance companies, and establish measurable treatment goals—reducing hours of manual documentation while ensuring compliance with insurance requirements and clinical standards.
by gptomics
You can create comprehensive, evidence-based perioperative pain management protocols tailored to individual patient characteristics and surgical requirements. The skill assesses patient risk factors, recommends optimized multimodal analgesia regimens with specific drug selections and dosing rationales, incorporates regional techniques when appropriate, and identifies contingency plans for inadequate pain control or contraindications. This enables you to move beyond generic guidelines toward truly personalized pain management strategies that reduce opioid exposure while maintaining analgesia.
by gptomics