Than et al developed the Emergency Department Assessment of Chest Pain Score (EDACS) for evaluating a patient with chest pain in the Emergency Department (ED). The authors are from multiple sites from New Zealand, Australia, the United States and the Netherlands.
Patient selection: >= 18 years of age with chest pain
Parameters:
(1) age in years
(2) gender
(3) known coronary artery disease (previous acute myocardial infarction, coronary artery bypass graft, percutaneous intervention)
(4) risk factors for coronary artery disease (family history of premature CAD, dyslipidemia, diabetes, hypertension, current smoking)
(5) diaphoresis
(6) pain radiates to arm or shoulder
(7) pain occurs or becomes worse with inspiration
(8) pain reproduced by palpation
|
Parameter
|
Finding
|
Points
|
|
age in years
|
18 to 45
|
2
|
|
|
46 to 50
|
4
|
|
|
51 to 55
|
6
|
|
|
56 to 60
|
8
|
|
|
61 to 65
|
10
|
|
|
66 to 70
|
12
|
|
|
71 to 75
|
14
|
|
|
76 to 80
|
16
|
|
|
81 to 85
|
18
|
|
|
>= 86
|
20
|
|
gender
|
male
|
6
|
|
|
female
|
0
|
|
CAD risk (see below)
|
no
|
0
|
|
|
yes
|
4
|
|
diaphoresis
|
no
|
0
|
|
|
yes
|
3
|
|
radiates to arm or shoulder
|
no
|
0
|
|
|
yes
|
5
|
|
pain on inspiration
|
no
|
0
|
|
|
yes
|
-4
|
|
pain reproduced by palpation
|
no
|
0
|
|
|
yes
|
-6
|
CAD risk if one or both of the following:
(1) age 18 to 50 AND known coronary artery disease
(2) age 18 to 50 AND >= 3 risk factors for CAD
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: -8
• maximum score: 34
Performance:
• The sensitivity is high (99 to 100%) while the specificity ranges from 50 to 59%.
