Interesting point from Amal Mattu.

What historical factors of CP are predictive of ACS?

1) association with diaphoresis

2) association with vomiting

3) association with exertion

4) radiating to both arms or right arm

 

All others are not predictive,  including: sub-sternal pressure, lightheadedness, nausea, and dyspnea.

 

Sources:

1. Swap CJ, Nagurney JT. Value and limitations of chest pain history in the evaluation of patients with suspected acute coronary syndromes. JAMA 2005;294:2623-2629.

2. Body R, Carley S, Wibberley C, et al. The value of symptoms and signs in the emergent diagnosis of acute coronary syndromes. Resuscitation 2010;81:281-286.

3. Panju AA, Hemmelgarn BR, Guyatt GH, et al. Is this patient having a myocardial infarction? JAMA 1998;280:1256-1263.