Conditions Provoking or Exacerbating Ischemia Increased Oxygen Demand Decreased Oxygen Supply Noncardiac Noncardiac Hyperthermia Hyperthyroidism Sympathomimetic toxicity (ie, cocaine use) Hypertension Anxiety Arteriovenous fistulae Anemia Hypoxemia Pneumonia Asthma Chronic obstructive pulmonary disease Pulmonary hypertension Interstitial pulmonary fibrosis Obstructive sleep apnea Sickle cell disease Sympathomimetic toxicity (ie, cocaine use, pheochromocytoma) Hyperviscosity Polycythemia Leukemia Thrombocytosis Hypergammaglobulinemia Cardiac Cardiac Hypertrophic cardiomyopathy Aortic stenosis Dilated cardiomyopathy Tachycardia Ventricular Supraventricular Aortic stenosis Hypertrophic cardiomyopathy Significant coronary obstruction Microvascular disease Modified from Gibbons et al.7 Table 9. Pretest Likelihood of CAD in Symptomatic Patients According to Age and Sex* (Combined Diamond/Forrester and CASS Data) Age, y Nonanginal Chest Pain Atypical Angina Typical Angina Men Women Men Women Men Women CAD indicates coronary artery disease; and CASS, Coronary Artery Surgery Study. * Each value represents the percent with significant CAD on catheterization. Adapted from Forrester and Diamond.52,73 Table 10. Comparing Pretest Likelihood of CAD in Low-Risk Symptomatic Patients With High-Risk Symptomatic Patients (Duke Database) Age, y Nonanginal Chest Pain Atypical Angina Typical Angina Men Women Men Women Men Women Each value represents the percentage with significant CAD. The first is the percentage for a low-risk, mid-decade patient without diabetes mellitus, smoking, or hyperlipidemia. The second is that of a patient of the same age with diabetes mellitus, smoking, and hyperlipidemia. Both high- and low-risk patients have normal resting ECGs. If ST-T-wave changes or Q waves had been present, the likelihood of CAD would be higher in each entry of the table. CAD indicates coronary artery disease; and ECG, electrocardiogram. 