Acute Coronary Syndrome & Chest Pain
Also: ACS · heart attack · myocardial infarction · angina
Acute coronary syndrome (ACS) spans unstable angina, NSTEMI and STEMI, and is a leading cause of acute chest pain presentations. Care depends on rapid risk stratification, ECG and troponin interpretation, and timely antiplatelet, anticoagulant and reperfusion decisions.
This hub gathers the chest-pain and ACS risk scores, the key drugs, and the relevant pathways and explainers.
Calculators & scores
- TIMI Risk Score for UA/NSTEMIAcute Coronary Syndrome
- GRACE ACS Risk ScoreAcute Coronary Syndrome
- HEART Score for Major Adverse Cardiac EventsChest Pain
- TIMI Risk Score for STEMIACS
- HEART Score (Chest Pain Risk)Chest Pain
- GRACE Score (ACS Risk)Acute Coronary Syndrome
- Rate-Pressure Product (RPP)Haemodynamics
- EDACS — Emergency Department Assessment of Chest PainChest Pain
- TIMI Risk Index for STEMIRisk Stratification
- HE-MACS (History and ECG-Based Manchester ACS Risk Score)ACS Risk Stratification
- HEAR Score for Acute Chest PainChest Pain
- ACTION ICU Score for Intensive Care in NSTEMIChest Pain
- Canadian Cardiovascular Society (CCS) Angina GradingCoronary Artery Disease
- ADAPT Protocol for Cardiac Event RiskChest Pain
Decision pathways
- NSTEMI / Unstable AnginaESC 2020 NSTEMI Guidelines; NICE NG185
- Acute Chest PainNICE CG95; ESC 2023 ACS Guidelines
- Acute Heart FailureESC 2021 Heart Failure Guidelines; NICE NG106
- Stable Angina Assessment and ManagementNICE NG185; ESC 2019 Chronic Coronary Syndromes Guidelines
- STEMI & ReperfusionESC 2023 ACS Guidelines; NICE NG185
- Cardiogenic ShockESC 2023 ACS; SCAI 2019
- Heart Failure — GDMT OptimisationESC 2021 HF; NICE NG106
- Adult Congenital Heart Disease — ED PresentationESC 2020 ACHD; ACC/AHA 2018 ACHD
Drugs
- Morphine (IV/IM — Anaesthesia/ICU)Strong Opioid Analgesic
- BisoprololAntihypertensive
- RamiprilAntihypertensive
- Enoxaparin (LMWH)Anticoagulant
- AtorvastatinLipid-Lowering
- TicagrelorAntiplatelet
- PrasugrelAntiplatelet
- Aspirin (Antiplatelet — ACS/PCI)Antiplatelet / ACS
- Clopidogrel (ACS / Post-PCI)Antiplatelet / ACS
- Glyceryl Trinitrate (Sublingual / IV)Nitrate / Acute Angina
- Glyceryl trinitrate (GTN)Organic nitrate
- Ramipril with felodipineACE inhibitor + dihydropyridine CCB
Patient explainers
Decision support only. These tools are aggregated by topic to aid navigation — always apply clinical judgement and the relevant national or local guideline.