High likelihood |
Any of the following features: |
Primary symptom is pain or discomfort in chest or left arm AND current pain is similar to pain of prior documented angina/MI |
Patient has known CHD OR MI |
Transient mitral regurgitation OR hypotension OR diaphoresis OR pulmonary edema OR rales |
New (or presumably new) transient ST deviation (≥1 mm) |
New T-wave inversion in multiple precordial leads |
Elevated cardiac troponin |
Intermediate likelihood |
Absence of high-likelihood features, a normal cardiac troponin, and presence of any of the following: |
Primary symptom is pain or discomfort in chest or left arm |
Older than 70 years of age |
Male |
Diabetes mellitus |
Extracardiac vascular disease |
Fixed Q waves |
ST depression 0.5 to 1 mm or T-wave inversion >1 mm |
Low likelihood |
Absence of high- or intermediate-likelihood features and a normal cardiac troponin. May have any of the following and still be low likelihood: |
History of symptoms that are probably ischemic |
Recent use of cocaine |
T-wave flattening or inversion <1 mm |
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