EDACS — Emergency Department Assessment of Chest Pain
Score for low-risk chest pain in the ED, intended for use with 2h serial troponin to identify patients safe for early discharge. Validated with high-sensitivity troponin.
Score interpretation
EDACS < 16: Low risk. If serial 2h hs-troponin both negative and no new ischaemic ECG changes: safe for discharge.
→ Apply EDACS-ADP (Accelerated Diagnostic Protocol): negative serial hs-troponin (0h + 2h) + no ST/T changes + EDACS < 16 = safe discharge. Arrange early outpatient follow-up within 72h. Stress testing or CTCA as outpatient.
EDACS ≥ 16 OR high-risk features: Not eligible for accelerated discharge. Standard ACS evaluation required.
→ Serial troponins (0, 3, 6h). Cardiology review. Manage per HEART score or local ACS protocol. Admission for monitoring.
Interpretation bands for the EDACS. Apply clinical judgement and local guidance.
References
- Than M et al. 2-Hour Accelerated Diagnostic Protocol to Assess Patients With Chest Pain Symptoms Using Contemporary Troponins as the Only Biomarker: The ADAPT Trial. J Am Coll Cardiol. 2012.
- Than MP et al. Development and validation of the Emergency Department Assessment of Chest Pain Score and 2h accelerated diagnostic protocol. Emerg Med Australas. 2014.
Related
Curated clinical cross-links plus same-class fallbacks.
- Labetalol (IV — Hypertensive Emergency) · Combined Alpha-1 and Beta-Adrenergic Blocker
- Labetalol (IV — Hypertensive Emergency) · Combined alpha and beta blocker
- Adrenaline (Anaphylaxis Protocol) · Auto-injector / IM adrenaline for anaphylaxis
- Tenecteplase · Cardiovascular Emergency
- Tirofiban · Cardiovascular Emergency
- Terlipressin · Gastrointestinal Emergency
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Featured in these MRCEM clinical pathways
The EDACS is covered in detail — with RCEM/NICE evidence base, indications and pitfalls — in the following exam-focused pathways on our sister siteReviseMRCEM.
MRCEM Primary / Intermediate / OSCE candidates: each pathway includes exam-style questions, RCEM/NICE citations, and FAQ summaries.
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.