Clinical features

• the pain: specifically 
  • its position ^band if it has moved ^c
  • its duration ^{a b c}  
  • its nature ^{a b}
  • any radiation ^a particularly to the right arm or shoulder ^b
  • any similarity to previous infarcts on angina attacks ^a
  • any exacerbating or relieving factors ^b  
• any associated nausea or vomiting ^b 
• any associated sweating ^b  
• a history of   
  • angina or MI ^{a b}
  • hypertension ^c 
  • asthma ^a
  • dementia ^a
  • immunosuppression ^a
  • Marfan's syndrome ^c

• a cough ^a  
  
• fever ^a
• respiratory rate > 30 per minute ^a
• tachycardia ^a
• hypertension ^c or hypotension  ^{b c}
  
• sweating ^b
• absent or reduced pulses  ^c
  
• a third heart sound ^b
• aortic regurgitation ^c
  
• chest pain that is reproduced on palpation ^{a b}
• asymmetric respiration ^a
• chest dullness on percussion ^a
• decreased breath sounds ^a
• bronchial breathing ^a
• crackles ^{a b}
• egophony ^a
  
• evidence of a stroke or paralysis ^b

In the elderly, the following features are less helpful at diagnosing a myocardial infarction ^a

• male sex
• pain location and similarity to previous myocardial infarction or angina
• ECG changes in the emergency department