Emergency Department Detection of Chest Pain Score (EDACS)

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.