View source for Template:Clinical features ACS

===Risk of [[Acute Coronary Syndrome]]===
Clinical factors that '''increase''' likelihood of ACS/AMI:<ref>Body R, Carley S, Wibberley C, et al. The value of symptoms and signs in the emergent diagnosis of acute coronary syndromes. Resuscitation. 2010;81(3):281–286. PMID: 20036454</ref><ref>Panju AA, Hemmelgarn BR, Guyatt GH, et al. The rational clinical examination. Is this patient having a myocardial infarction? JAMA. 1998;280(14):1256–1263. PMID: 9786377</ref>
*Chest pain radiating to both arms > R arm > L arm
*Chest pain associated with diaphoresis
*Chest pain associated with nausea OR vomiting
*Chest pain with exertion that is improved with rest

Clinical factors that '''decrease''' likelihood of ACS/AMI:<ref>Swap CJ, Nagurney JT. Value and limitations of chest pain history in the evaluation of patients with suspected acute coronary syndromes. JAMA. 2005;294(20):2623–2629. PMID: 16304077</ref>
*Pleuritic chest pain
*Positional chest pain
*Sharp, stabbing chest pain
*Chest pain reproducible with palpation

Gender differences in ACS 
*Women with ACS:
**Less likely to be treated with guideline-directed medical therapies<ref name=“Mehta 2016”> Mehta LS, et al. Acute myocardial infarction in women: A scientific statement from the American Heart Association. Circulation. 2016; 133:916-947.</ref>
**Less likely to undergo cardiac catheterization<ref name=“Mehta 2016”> Mehta LS, et al. Acute myocardial infarction in women: A scientific statement from the American Heart Association. Circulation. 2016; 133:916-947.</ref>
**Less likely to receive timely reperfusion therapy<ref name=“Mehta 2016”> Mehta LS, et al. Acute myocardial infarction in women: A scientific statement from the American Heart Association. Circulation. 2016; 133:916-947.</ref>
**More likely to report fatigue, dyspnea, indigestion, nausea or vomiting, palpitations, or weakness,<ref name=“Mehta 2016”> Mehta LS, et al. Acute myocardial infarction in women: A scientific statement from the American Heart Association. Circulation. 2016; 133:916-947.</ref> although some studies have found fewer differences in presentation<ref>Gimenez MR, et al. Sex-specific chest pain characteristics in the early diagnosis of acute myocardial infarction. JAMA Intern Med. 2014; 174(2):241-249.</ref>
*More likely to delay presentation<ref name=“Mehta 2016”> Mehta LS, et al. Acute myocardial infarction in women: A scientific statement from the American Heart Association. Circulation. 2016; 133:916-947.</ref>
*Men with ACS:
**More likely to report central chest pain 

Factors associated with delayed presentation<ref name=“Mehta 2016”> Mehta LS, et al. Acute myocardial infarction in women: A scientific statement from the American Heart Association. Circulation. 2016; 133:916-947.</ref>
: 
*Female sex
*Older age
*Black or Hispanic race
*Low educational achievement
*Low socioeconomic status