| High likelihood (e.g., 0.85-0.99) | Intermediate likelihood (e.g., 0.15-0.84) | Low likelihood (e.g., 0.01-0.14) |
|---|---|---|
| Any of the high or following features: | Absence of high likelihood features and any of the following: | Absence of intermediate likelihood features but may have: |
| History of prior MI or sudden death or other known history of CAD Definite angina: males > 60 or females > 70 years of age Transient hemodynamic or ECG changes during pain | Definite angina: males < 60 or females < 70 years of age Probable angina: males > 60 or females > 70 years of age Chest pain probably not angina in patients with diabetes | Chest pain classified as probably not angina One risk factor other than diabetes T-wave flattening or inversion < 1 mm in leads with dominant R waves |
| Variant angina (pain with reversible ST-segment elevation) | Chest pain probably not angina and two or three risk factors other than diabetes[1] | Normal ECG |
| ST segment elevation or depression > 1 mm Marked symmetrical T-wave inversion in multiple precordial leads | Extracardiac vascular disease ST depression 0.05 to 1 mm | |
| T-wave inversion > 1 mm in leads with dominant R-waves |
[1] Coronary artery disease risk factors include diabetes, smoking, hypertension, and elevated cholesterol.
Note: Estimation of the likelihood of significant coronary artery disease is a complex, multivariable problem that cannot be fully specified in a table such as this. Therefore, the table is meant to illustrate major relationships rather than offer rigid algorithms.
From: 3, Guideline: Outpatient Care
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