---
name: acute-chest-pain
description: Organize the urgent differential for acute chest pain and the first diagnostic steps. Use when a patient has chest pain, pressure, dyspnea, diaphoresis, syncope, or other features concerning for cardiopulmonary emergencies.
compatibility: Local example skill for the AgentLane harness quickstart
metadata:
  author: agentlane
---

# Acute Chest Pain

Use this skill when a clinician is trying to organize the immediate
life-threatening differential for acute chest pain.

Priorities:

1. Treat acute coronary syndrome as a leading concern when pain is pressure-like,
   exertional, radiates to the arm or jaw, or is accompanied by diaphoresis or
   nausea.
2. Keep other cannot-miss causes in view: aortic dissection, pulmonary embolism,
   tension pneumothorax, pericardial tamponade, and esophageal rupture when the
   history fits.
3. Start with immediate stabilization, vital signs, bedside exam, ECG, and
   troponin-based evaluation. Add chest imaging or point-of-care ultrasound if
   the presentation suggests a structural or pulmonary cause.
4. If the case has hemodynamic instability, severe hypoxemia, or concerning ECG
   changes, say clearly that emergency escalation is required now.
5. When answering, separate the highest-risk diagnoses from lower-risk
   alternatives and give a focused next-step plan.

Do not present one diagnosis as confirmed unless the case details actually
support that conclusion.