Emergency Department Detection of Chest Pain Score (EDACS)

Identifies chest pain patients at low-risk for major adverse cardiac events


The Emergency Department (ED) Detection of Chest Pain Score (EDACS) is a derived and validated accelerated diagnostic protocol designed to identify patients with chest pain who are low-risk for major adverse cardiac events (MACE). In conjunction with an EKG showing no new ischemia and two negative troponins (at 0- and 2-hours), this tool is >99% sensitive for MACE and allows for safe discharge from the ED with outpatient follow-up as appropriate.

The score was derived1 in 2014, and compared to another CDR for chest pain in a prospective RCT2 of 558 patients. The negative predictive value (NPV) in this comparison and subsequent validation study3 was 100%. EDACS is a highly sensitive tool that can reduce patient length of stay and improve identification of low-risk patients presenting with chest pain to the emergency department.

Variable & Associated Points

Age scored as per below, must be 18 or older

  • 18 - 45 (+2)
  • 46 - 50 (+4)
  • 51 - 55 (+6)
  • 56 - 60 (+8)
  • 61 - 65 (+10)
  • 66 - 70 (+12)
  • 71 - 75 (+14)
  • 76 - 80 (+16)
  • 81 - 85 (+18)
  • ≥86 (+20)

Sex M/F (male +6; female 0)

Age 18-50 AND known coronary artery disease (CAD) or ≥3 risk factors (Yes +4; No 0)

CAD defined by: previous ACS, previous CABG, or previous PCI

Risk factors defined by: hypertension, dyslipidemia, diabetes, current smoker, family history of early CAD

Diaphoresis (Yes +3, No 0)

Pain radiates to arm, shoulder, neck, or jaw (Yes +5, No 0)

Pain occurred or worsened with inspiration (Yes -4, No 0)

Pain reproduced by palpation (Yes -6, No 0)

The total EDACS score is determined by the sum of variables listed above.

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1. Age?

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