Clinical factors that increase likelihood of ACS/AMI:<unk> <unk>  radiating to both arms > R arm > L arm<unk> <unk>  associated with diaphoresis<unk> <unk>  associated with nausea/vomiting<unk> <unk>  with exertion
Clinical factors that decrease likelihood of ACS/AMI:
Pleuritic<unk> <unk> 
Positional<unk> <unk> 
Sharp, stabbing<unk> <unk> <unk> <unk>  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<unk> <unk> 
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<unk> <unk> 
Factors associated with delayed presentation
Female sex
Older age
Black or Hispanic race
Low educational achievement
Low socioeconomic status
Acute chest pain
Acute coronary syndromes 
Unstable angina
STEMI
Acute dyspnea 
Non-STEMI
Acute dyspnea
Stable angina