Diaphoresis Observed by Clinician

Absent+0Present (sweating observed at evaluation)+3

Pain Radiates to Left Arm or Left Shoulder

Absent+0Present+2

Chest Pain Worsened over Past 24 Hours

Absent or pain unchanged/improving+0Present (pain has worsened over the past 24h)+2

Vomiting Associated with Chest Pain

Absent+0Present (vomiting occurred with this episode of chest pain)+2

Sweating Reported by Patient (Not Observed)

Absent+0Present (patient reports sweating during this episode)+1

ST Segment Depression on ECG (≥ 0.5 mm, New or Uncertain Age)

Absent+0Present (new or uncertain-age ST depression ≥ 0.5 mm in ≥ 2 contiguous leads)+3

New T-Wave Inversion on ECG

Absent+0Present (new symmetric T-wave inversions ≥ 1 mm in ≥ 2 contiguous leads)+2

Syncope or Near-Syncope with This Episode

Absent+0Present (loss of consciousness or near-fainting with this chest pain episode)+3

History and Electrocardiogram-only Manchester Acute Coronary Syndromes (HE-MACS)