Clinical factors that increase likelihood of ACS/AMI:
Chest pain radiating to both arms > R arm > L arm
Chest pain associated with diaphoresis
Chest pain associated with nausea/vomiting
Chest pain with exertion
Clinical factors that decrease likelihood of ACS/AMI:
Pleuritic chest pain
Positional chest pain
Sharp, stabbing chest pain
Chest pain reproducible with palpation
Gender differences in ACS
Women with ACS:
Less likely to be treated with guideline-directed medical therapies
Less likely to undergo cardiac catheterization
Less likely to receive timely reperfusion therapy
More likely to report fatigue, dyspnea, indigestion, nausea or vomiting, palpitations, or weakness, although some studies have found fewer differences in presentation
More likely to delay presentation
Men with ACS:
More likely to report central chest pain
Less likely to be treated with guideline-directed medical therapies
Less likely to undergo cardiac catheterization
Less likely to receive timely reperfusion therapy
More likely to report fatigue, dyspnea, indigestion, nausea or vomiting, palpitations, or weakness, although some studies have found fewer differences in presentation
More likely to report central chest pain
Factors associated with delayed presentation
Female sex
Older age
Black or Hispanic race
Low educational achievement
Low socioeconomic status
Signs/symptoms may include
Chest pain
SOB
Dizziness/lightheadedness, syncope/presyncope
Nausea/vomiting
Diaphoresis
Anxiety, sense of impending doom
Palpitations
Dysrhythmias
Cardiac arrest
ST-segment elevation myocardial infarction
Cardiac
Non-ST-elevation myocardial infarction
ST-segment elevation myocardial infarction 
Unstable angina
Post-MI 
Acute coronary syndrome 
Previous MI with recurrent ischemia in same area