Dr KKs Rules in managing chest pain

  1. Dr KK Aggarwal
    Padma Shri and Dr B C Roy National Awardee

    President, Heart Care Foundation of India

  2. 1. Rule of 30 seconds: Chest pain, burning, discomfort, heaviness in the center of the chest lasting for over 30 seconds and not localized to a point unless proved otherwise is a heat pain. To this rule, add the rule of pin pointing finger i.e. any chest pain which can be pin pointed by a finger is not a heart pain.

2. Rule of 5: If you suspect a heart attack, do not wait for more than five minutes and get to a hospital right away.

3. Rule of 3: Reach hospital within 3 hours in case of heart attack to receive clot-removing angioplasty or clot-dissolving drugs.

4. Rule of 300: Chew a tablet of water-soluble 300 mg aspirin and take 300 mg clopidogrel tablets at the onset of cardiac chest pain (heart attack) to reduce mortality.

5. Rule of 10: Door-to-ECG time is the time within which an ECG should be done in the emergency room and it should be less than 10 minutes.

6. Rule of 30: Door-to-needle time in acute heart attack is the time before which the clot-dissolving drug should be given after a patient reaches the hospital. In ST elevation heart attack, the door-to-needle time should be less than 30 minutes.

7. Rule of 40: First-onset acidity or first-onset asthma after the age of 40: Rule out heart attack or heart asthma.

8. Rule of 90: Door-to-balloon time is the ideal time for primary percutaneous coronary intervention in acute heart attack by an experienced operator and should be less than 90 minutes.

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