Introduction: Acute chest pain is a common symptom among prehospital emergency care patients.Therefore, it is crucial that ambulance nurses (ANs) have the ability to identify symptoms and assesspatients suffering from acute coronary syndrome (ACS). The aim of this study is to explore the occurrenceof dyspnoea and nausea and/or vomiting in the prehospital phase of a suspected ACS and the associationswith patients’ outcome.

Methods: This study has a quantitative design based on data from hospital records and from a previousinterventional study (randomised controlled trial) including five Emergency Medical Service (EMS) systemsin western Sweden in the years 2008–2010.

Results: In all, 1836 patients were included in the interventional study. Dyspnoea was reported in 38%and nausea and/or vomiting in 26% of patients. The risk of death within one year increased with the presenceof dyspnoea. The presence of nausea and/or vomiting increased the likelihood of a final diagnosis ofacute myocardial infarction (AMI).

Conclusion: This study shows that dyspnoea, nausea and/or vomiting increase the risk of death and seriousdiagnosis among ACS patients. This means that dyspnoea, nausea and/or vomiting should influencethe ANs’ assessment and that special education in cardiovascular nursing is required.