Screening and diagnosis

Classification and risk stratification

Perioperative care

Quality improvement

Patient education

Nonpharmacologic interventions

Therapeutic procedures

Respiratory support

Follow-up and surveillance

Specific circumstances

Preventative measures

Medical management

Surgical interventions

Inpatient care

Diagnostic procedures

Diagnostic investigations

Insufficient evidence to make a recommendation.

Strongly favor this test or intervention.

The calculator in question is the COVADIS criteria, which stands for the Coronary Vasomotion Disorders International Study Group diagnostic criteria for vasospastic angina. This calculator is specifically applicable to patients who are suspected of having vasospastic angina, a condition characterized by spasms in the coronary arteries which can cause chest pain.

The clinical utility of the COVADIS criteria is to aid in the diagnosis of vasospastic angina. It does this by considering various factors such as the patient's symptoms, the results of coronary angiography, and the response to medications like calcium channel blockers. 

There are no specific exclusion criteria for the use of the COVADIS criteria. However, it should be noted that this calculator is intended to be used by healthcare professionals and should not replace clinical judgment. It is also important to consider other potential causes of chest pain when using this calculator.

Coronary Vasomotion Disorders International Study Group diagnostic criteria for vasospastic angina (COVADIS criteria)

# Criteria
 # Nitrate-responsive angina (during spontaneous episodes)
A. Rest angina, especially between night and early morning
B. Marked diurnal variation in exercise tolerance, reduced in the morning
C. Hyperventilation can precipitate an episode
D. Calcium channel blockers (but not beta-blockers) suppress episodes
# Transient ischemic electrocardiogram changes (during spontaneous episodes, in at least 2 contiguous leads)
E. ST-segment elevation >= 0.1 mV
F. ST-segment depression >= 0.1 mV
G. New negative U waves
# Coronary artery spasm
H. Transient total or subtotal coronary artery occlusion (> 90% constriction)
I. Angina and ischemic electrocardiogram changes either spontaneously or in response to a provocative stimulus (typically acetylcholine, ergot, or hyperventilation)

# Conditions
- (A or B or C or D) and (E or F or G) and H and I
- true

The Japanese Coronary Spasm Association (JCSA) risk score for major cardiac events in vasospastic angina is a clinical calculator used in cardiology. This scoring system is specifically designed for patients diagnosed with vasospastic angina, a condition characterized by spasms in the coronary arteries which can lead to chest pain, arrhythmias, and myocardial infarction.

The JCSA score is used to predict the risk of major cardiac events in these patients, including cardiac death, nonfatal myocardial infarction, and hospitalization due to unstable angina. The score is calculated based on several factors including age, smoking status, hypertension, dyslipidemia, diabetes mellitus, multi-vessel spasm, and ST-segment elevation during spasm.

The clinical utility of the JCSA score lies in its ability to stratify patients according to their risk level, thereby guiding clinicians in making informed decisions about the intensity of treatment and follow-up required. 

There are no specific exclusion criteria for the use of the JCSA score, but it is primarily intended for use in patients with a confirmed diagnosis of vasospastic angina. It may not be applicable or accurate in patients with other types of angina or coronary artery disease.

Japanese Coronary Spasm Association risk score for major cardiac events in vasospastic angina (JCSA score)

# Criteria
 A. History of out-of-hospital cardiac arrest (+4)
B. Smoking (+2)
C. Angina at rest alone (+2)
D. Significant organic coronary artery stenosis (+2)
E. Multivessel spasm (+2)
F. ST-segment elevation during angina (+1)
G. Beta-blocker use (+1)

# Conditions
- score >= 6
- score >= 3
- score <= 2
- score == 0

The NYHA functional classification for heart failure, or New York Heart Association Functional Classification, is a scoring system used to quantify the severity of symptoms in patients with heart failure. This classification system is applicable to patients diagnosed with heart failure and is used to assess their functional capacity and limitations during physical activity. 

The NYHA classification is divided into four classes: Class I (no symptoms and no limitation in ordinary physical activity), Class II (mild symptoms and slight limitation during ordinary activity), Class III (marked limitation in activity due to symptoms, even during less-than-ordinary activity), and Class IV (severe limitations, experiences symptoms even while at rest).

The clinical utility of this calculator is to guide treatment decisions, assess prognosis, and evaluate the effectiveness of therapeutic interventions in patients with heart failure. It is also commonly used in clinical trials to stratify patients and measure outcomes. 

There are no specific exclusion criteria for its use, but it is subjective and relies on patient self-report, so it may not be as accurate in patients with cognitive impairment or communication difficulties.

NYHA functional classification for heart failure

# Criteria
 ## Physical ability
A. Patients with cardiac disease, but without limitation of physical activity. Ordinary physical activity does not cause undue fatigue, palpitation, or dyspnea.
B. Patients with cardiac disease resulting in slight limitation of physical activity. Comfortable at rest, but ordinary physical activity results in fatigue, palpitation, or dyspnea.
C. Patients with cardiac disease resulting in marked limitation of physical activity. Comfortable at rest, but less than ordinary activity causes fatigue, palpitation, dyspnea or anginal pain.
D. Patients with cardiac disease resulting in inability to carry on any physical activity without discomfort. Symptoms of heart failure at rest, if any physical activity is undertaken, discomfort increases.

# Conditions
- A
- B
- C
- D
- true