For healthcare professionals
EDACS chest pain score calculator
The Emergency Department Assessment of Chest pain Score (EDACS) is a clinical score for adults seen in the emergency department with possible acute coronary syndrome. It adds points for age, male sex, coronary history in younger patients, sweating and radiating pain, and takes points away for pain that is worse on breathing in or reproduced by pressing on the chest. Combined with the ECG and troponin at 0 and 2 hours, it was built to find patients at low risk. This calculator is written for clinicians and is not a diagnosis.
Findings at the emergency department visit
For adults with possible acute coronary syndrome, after ST elevation myocardial infarction has been ruled out. Nothing you enter leaves this page.
What you will see
The EDACS total, the points for each item, and whether the patient meets the low-risk criteria of the EDACS pathway (score under 16, no new ischaemia on the ECG, negative troponin at 0 and 2 hours).
Educational only, not medical advice. Not a diagnosis and not a decision on discharge or admission.
Source
Than M and colleagues, Emergency Medicine Australasia 2014, derived EDACS. Because that paper is not open access, the points here are taken from two open-access (CC BY 4.0) papers that reprint the score: Huis in 't Veld and colleagues, Western Journal of Emergency Medicine 2017, and Miranda-Chavez and Amado-Tineo, Archivos Peruanos de Cardiología y Cirugía Cardiovascular 2025. Both print the same points. The tests check every age band, each item and the cut point of 16.
Validated in
Adults seen in the emergency department with possible acute coronary syndrome. The derivation cohort came from patients enrolled in the ADAPT study (1,974 patients), with a validation cohort of 608 patients; together they classed 40 to 50% of patients as low risk (Huis in 't Veld 2017).
Limits
EDACS is meant to be used together with the ECG and troponin at 0 and 2 hours, not on its own. The first U.S. validation study found lower sensitivity for major adverse cardiac events than the derivation work (Huis in 't Veld 2017). In a retrospective study of 249 patients at one tertiary hospital in Lima, Peru, EDACS predicted 30-day major adverse cardiovascular events less well than the HEART score (area under the curve 0.70 versus 0.91) (Miranda-Chavez 2025). The score does not apply to ST elevation myocardial infarction and does not replace clinical judgement or the local chest pain pathway.
EDACS points
Add the points for each item that applies (Huis in 't Veld 2017) (Miranda-Chavez 2025).
| Item | Points |
|---|---|
| Age 18 to 45 | +2 |
| Age 46 to 50 | +4 |
| Age 51 to 55 | +6 |
| Age 56 to 60 | +8 |
| Age 61 to 65 | +10 |
| Age 66 to 70 | +12 |
| Age 71 to 75 | +14 |
| Age 76 to 80 | +16 |
| Age 81 to 85 | +18 |
| Age 86 or older | +20 |
| Male sex | +6 |
| Aged 18 to 50 and either known coronary artery disease or 3 or more risk factors | +4 |
| Diaphoresis | +3 |
| Pain radiates to the arm, shoulder, neck or jaw | +5 |
| Pain occurred or worsened with inspiration | -4 |
| Pain is reproduced by palpation | -6 |
Known coronary artery disease means a previous heart attack, coronary bypass surgery or PCI. The risk factors counted are dyslipidaemia, diabetes, hypertension, current smoking and a family history of premature coronary artery disease (Miranda-Chavez 2025). Totals run from -8 to 34.
Two notes on the reprints. The 2017 table prints the second-highest age band as "81 - 55", a typo; the 2025 table prints 81 to 85, which is used here. The 2017 table words radiation as "to arm or shoulders", while the 2025 table names the arm, shoulder, neck or jaw; this calculator uses the fuller wording. The score was first published by Than and colleagues in 2014 (Than 2014).
The low-risk pathway
In the EDACS accelerated diagnostic pathway, a patient is low risk with an EDACS under 16, no new ischaemia on the ECG and a negative troponin at 0 and 2 hours. A score of 16 or more is not low risk (Huis in 't Veld 2017) (Miranda-Chavez 2025). In the derivation work, patients meeting these criteria were described as safe for discharge without further workup, and a randomized trial comparing EDACS with the ADAPT pathway found more patients classed as low risk with EDACS and no 30-day major adverse cardiac events among them (Huis in 't Veld 2017). Validation results since then have varied (see the limits above), so local chest pain pathways and current guidelines should guide disposition.
Related tools
For another emergency chest pain score, see the HEART score calculator. Once unstable angina or NSTEMI is diagnosed, see the TIMI risk score calculator. For suspected pulmonary embolism, see the Wells score for PE and the PERC rule. More scores are listed under calculators for healthcare professionals.
Sources
- Huis in 't Veld MA, Cullen L, Mahler SA, Backus BE, Dezman ZDW, Mattu A. The Fast and the Furious: Low-Risk Chest Pain and the Rapid Rule-Out Protocol. West J Emerg Med. 2017;18(3):474-478. doi:10.5811/westjem.2016.12.32676. PMID 28435499. CC BY 4.0. EDACS section and Table 3. pmc.ncbi.nlm.nih.gov/articles/PMC5391898/
- Miranda-Chavez J, Amado-Tineo J. Prediction of major adverse cardiovascular events with two risk scales for acute chest pain in the emergency department. Arch Peru Cardiol Cir Cardiovasc. 2025;6(4):215-222. doi:10.47487/apcyccv.v6i4.555. PMID 41582929. CC BY 4.0. Methods, Results and Table 3. pmc.ncbi.nlm.nih.gov/articles/PMC12825433/
- Than M, Flaws D, Sanders S, et al. Development and validation of the Emergency Department Assessment of Chest pain Score and 2 h accelerated diagnostic protocol. Emerg Med Australas. 2014;26(1):34-44. doi:10.1111/1742-6723.12164. PMID 24428678. Original derivation paper (cited, not quoted). doi.org/10.1111/1742-6723.12164
Written and maintained by the uncovermyrisk.com editorial team. We do not have a medical reviewer; every claim links to its primary source above. Last reviewed: 2026-11-03. Spotted an error? See About.