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OR rales New (or presumably new) transient ST deviation (≥1 mm) New T-wave inversion in multiple precordial leads Elevated cardiac troponin or CK-MB levels Intermediate likelihood Absence of high likelihood features 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 Normal cardiac troponin or CK-MB levels Low likelihood Absence of high or intermediate likelihood features. 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 Note: T-wave inversion refers to a T-wave with opposite polarity to the dominant QRS in that lead. CK-MB: creatine kinase MB fraction; MI: myocardial infarction; CHD: coronary heart disease. Adapted from: Anderson J, Adams C, Antman E, et al. ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 2002 Guidelines for the Management of Patients with Unstable Angina/Non-ST-Elevation).