Summary
Definition
History and exam
Key diagnostic factors
- chest pain
- dyspnea
- pallor
- diaphoresis
- cardiogenic shock
Other diagnostic factors
- nausea and/or vomiting
- dizziness or lightheadedness
- weakness
- distressed
- tachycardia
- additional heart sounds
- atypical location or nature of pain
- reduced consciousness
- hypotension
- abnormal breath sounds
Risk factors
- smoking
- hypertension
- diabetes
- obesity
- metabolic syndrome
- physical inactivity
- dyslipidemia
- renal insufficiency
- established coronary artery disease
- family history of premature coronary artery disease
- cocaine use
- male sex
- advanced age
Diagnostic investigations
1st investigations to order
- ECG
- cardiac biomarkers
- glucose
- electrolytes, BUN, and creatinine
- serum lipids
- CXR
- coronary angiogram
Treatment algorithm
Contributors
Authors

Director, Cardiac MRI
Clinical Associate Professor of Medicine and Radiology
Division of Cardiology
Department of Internal Medicine
University of Iowa Hospitals and Clinics
University of Iowa Health Care
Iowa
IA
Disclosures
MLA declares that she has no competing interests.
Director, Endovascular Cardiology
Associate Professor of Medicine, Endovascular Cardiology
Case Western Reserve University
Cleveland
OH
Disclosures
SG declares that he has no competing interests.
Dr Mahi L. Ashwath and Dr Sanjay Gandhi would like to gratefully acknowledge Dr Thomas Vrobel, a previous contributor to this topic. TV declares that he has no competing interests.
Peer reviewers
Vice Chairman of Medicine for Network Development and Strategic Planning
Brigham and Women's Hospital
Boston
MA
Disclosures
DA declares that he has no competing interests.
Associate Professor of Medicine
Department of Cardiovascular Medicine
Cleveland Clinic
OH
Disclosures
DLB declares that he has no competing interests.
Consultant Cardiologist and Professor of Cardiovascular Medicine
University Department of Medicine
City Hospital
Birmingham
UK
Disclosures
GL declares that he has no competing interests.
Use of this content is subject to our disclaimer