Coronary Artery Bypass Graft (CABG)

Congestive Heart Failure (CHF)

Coronary revascularization procedure (CABG or PTCA)

Peripheral Arterial Disease (PAD)

Percutaneous Transluminal Coronary Angioplasty (PTCA)

Cardiac enzyme information available?

CK-MB at least 2x upper limit of normal for % or index

CK-MB greater than upper limit of normal but less than 2x upper limit of normal for % or index

CK-MB within normal limits for % or index

CK-MB at least 2x upper limit of normal for units

CK-MB greater than upper limit of normal but less than 2x upper limit of normal for units

CK-MB within normal limits for units

CK-MB reported as "present” without quantification

CK-MB reported as “weakly present” without quantification

Total CK at least 2x upper limit of normal

Total CK greater than upper limit of normal but less than 2x upper limit of normal

Serum lactate dehydrogenase (LDH): (Complete only if no other cardiac enzymes are available.)

Results (Mark the one category that applies best.) Troponin values should be coded using the upper limit of normal (ULN) and not upper limit of indeterminate/indecisive as the reference value. Thus, if 2 cutpoints are given, choose the lower cutpoint for the upper limit of normal.

Cardiac pain defined as: an acute episode of pain, discomfort or tightness in the chest, arm, throat or jaw

Was a thrombolytic agent administered or emergent revascularization procedure (e.g., angioplasty or stent) performed?

Was the myocardial infarction aborted? (Diagnosis of an aborted MI requires: symptoms and ECG evidence for acute MI at presentation; intervention [thrombolytic therapy or a procedure] followed by resolution of ECG changes; and all cardiac enzymes within normal limits.)

Was the myocardial infarction fatal?

Angina based on: Physician diagnosis of angina and receiving medical treatment at discharge, for angina on this admission (e.g., nitrate, beta-blocker, or calcium-channel blocker)

Angina based on: Physician diagnosis of angina and receiving medical treatment for angina on this admission plus current medical record documenting a history of coronary heart disease by previous catheterization or revascularization procedure

Angina based on: CABG surgery or other revascularization procedure on this admission.

Angina based on: 70% or greater obstruction of any coronary artery on angiography on this admission

Angina based on: Horizontal or down-sloping ST-segment depression or abnormal ST elevation >= 1 mm on exercise or pharmacological stress testing with pain on this admission

Angina based on: Scintigraphic or echocardiographic stress test positive for ischemia on this admission

Angina based on: Resting ECG shows horizontal or down-sloping ST depression or abnormal ST elevation >= 1 mm with pain that is not present on ECG without pain on this admission

CHF based on: Congestive failure diagnosed by physician and receiving medical treatment for CHF on this admission (e.g., diuretic, digitalis, vasodilator and/or angiotensin-converting enzyme inhibitor)

CHF based on: Congestive failure diagnosed by physician and receiving medical treatment on this admission plus current medical record documents a history of an imaging procedure showing impaired systolic or diastolic LV function

CHF based on: Pulmonary edema\congestion by chest X-ray on this admission

CHF based on: On this admission, dilated ventricle or poor left (or right-side) ventricular function (e.g., wall motion abnormalities) by echocardiography; radionuclide ventriculogram (RVG)/multigated acquisition (MUGA), or other contrast ventriculography, or evidence of left ventricular diastolic dysfunction

Was the congestive heart failure fatal?

Second myocardial infarction (MI) (i.e., second MI not already reported in Question 4) occurring as a result of or during the revascularization procedure.

Diagnosis: (Mark the one category that applies best.)

PAD based on: Ultrasonographically- or angiographically-demonstrated obstruction, or ulcerated plaque (>= 50% of the diameter or >= 75% of the cross-sectional area) demonstrated on ultrasound or angiogram of the iliac arteries or below

PAD based on: Absence of pulse by doppler in any major vessel of lower extremities

PAD based on: Exercise test that is positive for lower extremity claudication

PAD based on: Surgery, angioplasty, or thrombolysis for peripheral arterial disease

PAD based on: Amputation of one or more toes or part of the lower extremity because of ischemia or gangrene

PAD based on: Exertional leg pain relieved by rest and at least one of the following: (1) claudication diagnosed by physician, or (2) ankle-arm systolic blood pressure ratio <= 0.8

PAD based on: Ultrasonographically- or angiographically-demonstrated abdominal aortic aneurysm

PAD based on: Surgical or vascular procedure for abdominal aortic aneurysm