In the search for a more reliable ACS Risk Stratification Tool, none were found that were deemed consistently reliable enough for use as an adjunct to clinical decision making. This could be due, in part, to the fact that the tools currently available (TIMI, GRACE, PURSUIT), were primarily designed as prognostic indicators of mortality in patients diagnosed with ST Segment Elevation Myocardial Infarction (STEMI) in pharmaceutical studies - not as tools to assess the probability that ACS exists in patients presenting to the Emergency Department. This prompted the development of the SACS Score.