📋 Likelihood Ratios: ACS/MI

⬆️ Increases suspicion:
• Right arm/shoulder radiation: 4.7
• Both arms radiation: 4.1
• Exertional pain: 2.4
• Diaphoresis: 2.0
• Pressure quality: 1.3

⬇️ Decreases but does NOT exclude:
• Pleuritic: 0.2
• Positional/Sharp/Reproducible: 0.3

Probability modifiers, NOT diagnosis closers.