King-Shier K, et al. - Given that successful treatment of acute coronary syndrome (ACS) relies on its rapid recognition, researchers analyzed potential ethnic variations in ACS symptoms using a rigorously cross-culturally adapted symptom questionnaire and visual identifiers in a multicenter cohort of white, South Asian, and Chinese patients (n=1,334) hospitalized in Canada. Midsternal pain/discomfort of any intensity regardless of ethnic status was the most common presenting symptom in this cross-sectional survey. A significant proportion of patients, however, reported atypical symptoms. In South Asians, atypical presentations were associated with greater delays in arriving at the emergency department and reduced invasive cardiovascular care.