MDCalc

Troponin-only Manchester Acute Coronary Syndromes (T-MACS) Decision Aid

Rules out acute coronary syndrome.

EKG ischemia
As determined by treating clinician
Worsening or crescendo angina
Pain radiating to right arm or shoulder
Pain associated with vomiting
Sweating observed
As observed by treating clinician
Hypotension
sBP <100 mmHg on arrival to ED

Result:

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Critical Actions
  • T-MACS is a decision aid and not a definitive test. It is designed to assist in the workup of a patient’s chest pain. Clinical judgment should always be used.
  • If all the components of the T-MACS decision aid are negative, ACS can essentially be ruled out without having to calculate the score.