The ability to design an institute an accurate triage system for chest pain is integral to the ability of medical institutions to serve their given both the severity of cardiac problems as well as the complexities that tend to lead to misdiagnosis of cardiac events. This paper examines the elements of triage for chest pain that can lead to as many accurate diagnosis as possible. This goal includes both the subgoals of avoiding sending home patients who are at risk of serious and even potentially fatal cardiac problems while at the same time meeting the subgoal of not hospitalizing (at both high physical and emotional costs) patients who are not in fact at risk of serious cardiac problems.