What is ACS? Acute Coronary Syndrome is an umbrella term for conditions caused by acute myocardial ischemia due to coronary artery occlusion. The three main entities are: 1. ST-Elevation Myocardial Infarction (STEMI) – complete coronary occlusion with transmural infarction. 2. Non-ST-Elevation Myocardial Infarction (NSTEMI) – partial occlusion with myocardial injury (positive troponin)

HEART score (History, ECG, Age, Risk factors, Troponin) Purpose: rapid ED risk-stratification for patients with chest pain to estimate short-term risk of major adverse cardiac events (MACE) and guide safe discharge vs observation/admission. Components & scoring (each 0–2 points): * History — subjective clinical gestalt about the chest-pain story: * 0

There are 3 heart causes, 2 lung causes, and one esophageal cause ACS/MI Clinical Presentation: * Chest pain (pressure, squeezing), radiates to left arm or jaw * Diaphoresis, dyspnea, nausea, palpitations * May be silent in diabetics or elderly Diagnostic Labs/Imaging: * ECG: ST-elevation (STEMI), ST-depression or T-wave inversion (NSTEMI/UA) * Cardiac