You are on page 1of 1

PAGE 15

CARDIOLOGY
National Clinical Priority Assessment Criteria (CPAC)
CARDIAC CATHETERISATION
Patient ID: Complete patient details or place patient sticker here

Nat. Hospital No.: Consultant:

Name: D.O.B.
Name of Assessor:
Address:

Date of Assessment:

1. ANGINA ON B BLOCKER AND/OR C ANTAGONIST


Nil 0
Class I 2
Class II 10
Class III 20
Class IV-A 25
Class IV-B 30 Maximum 35
Class IV-C 35

2. ETT ON B BLOCKER AND/OR C ANTAGONIST


Markedly Postive 20
Very Positive 16
Positive 8
Mildly Positive 4 Maximum 20
Negative 0

3. OTHER DIAGNOSES (MAX 30 POINTS)


Moderate Valvular HD +15
Severe Valvular HD +30
Severe LV Impairment +20
Moderate LV Impairment +10
Early Instability Post MI +15 Maximum 30
Recent Unstable Angina with ST/T Wave Changes +15

4. ABILITY TO WORK, GIVE CARE TO DEPENDENT(S) OR LIVE INDEPENDENTLY


Immediately threatened 15
Threatened but not immediate 5 Maximum 15
Not threatened but more difficult 1

URGENT CATHETER IF: SEMI URGENT IF:


Total Score =
Class IV angina Class III Angina
Markedly positive ETT Very positive
Class III and very positive ETT Class III and positive
Severe valvular HD Class II and very positive