INTERCHEST Rule (Chest Pain, CAD)

INTERCHEST rule (Aerts 2017): probability that chest pain is coronary in primary care.

Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.

Example

Age
60 years
Sex
Male
History of coronary artery disease
Yes
Pain feels like pressure
Yes
Pain reproducible by palpation
Yes

Result: INTERCHEST 2 — CAD not excluded (probability about 43%); expedite cardiac testing.

The tool opens with these values already filled in. Replace them with your own.

What the result means

< 2
CAD unlikely (probability ~2.1%, NPV ~98%).
>= 2
CAD not excluded (~43%); expedite cardiac testing. Primary-care rule, not for ED acute-coronary-syndrome triage.

What you enter

  • Age (years)
  • Sex
  • History of coronary artery disease
  • Pain brought on by exertion
  • Pain feels like pressure
  • Physician initially suspected a serious / cardiac cause
  • Pain reproducible by palpation (subtracts 1)
How this is calculated
Points
age/sex (F>=65 or M>=55) +1, history of CAD +1, exertional pain +1, pressure-like pain +1, physician suspected cardiac +1, reproducible by palpation -1 = -1 to +5.

Aerts M, Minalu G, Bosner S, et al. Pooled individual patient data from five countries were used to derive a clinical prediction rule for coronary artery disease in primary care. J Clin Epidemiol. 2017;81:120-128. Read the source ↗

A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.

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Built by Clay Good. Source on GitHub.