Likelihood of ACS

Chest pain that is pleuritic, sharp, positional and reproducible on palpation makes an alternative diagnosis much more likely. This information, in addition to other rapidly available clinical features (e.g. examination findings and the ECG), will determine the continued direction of investigation and initial management.

To refresh your memory on the diagnostic approach to patients with chest pain, click this thumbnail image:

Learning Bite

Characteristics of the pain with the highest likelihood for AMI are radiation of the pain to the right arm/shoulder or to both arms/shoulders.