Last Updated on May 26, 2022
ACS evaluations account for 10 – 20% of chest pain in ED. Therefore, when patients present with chest pain, it must be clerked properly!
SOCRATES
• S: retrosternal / localized pain / left or right sided
• O: when does the pain start?
• C: pressure / sharp
• R: jaw / left shoulder / arms
• A: relieved by nitrates within minutes?
• T: how long does the pain last?
• E: at rest / exercise/cold/emotion, perspiration, nausea/vomiting
• S: nausea / vomiting / palpitations / diaphoresis
Notes
• Always ask whether the pain is at rest / upon exertion (especially if suspecting ACS)
Relevant History
Patient’s background
• Smoking (current, or smoking cessation ≤3 mo)
• Obesity (BMI >30 kg/m²)
Co-morbidities
• History of MI / PCI / CABG
• History of CVA / TIA
• Hypertension
• Diabetes mellitus
• Dyslipidaemia
• Peripheral vascular disease
Family history
• Family Hx of premature cardiovascular disease
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