However, patients presenting with UA are subdivided by their short-term risk (Table 2). Patients at high or moderate risk often have experienced rupture of coronary artery plaque and have a risk of death higher than that of patients with stable angina but not as great as that of patients with AMI. These patients should be transferred promptly to an emergency department for evalu- ation and treatment. The short-term prognosis of patients with low-risk UA, however, is comparable to those with stable angina, and their evaluation can be conducted safely and expeditiously in an outpatient setting. After thorough characterization of chest pain, the presence of risk factors for IHD55 should be determined. These include smoking, hyperlipidemia, diabetes mellitus, hypertension, obesity or metabolic syndrome, physical inactivity, and a family history of premature IHD (ie, onset in a father, brother, or son before age 55 years or a mother, sister, or daughter before age 65 years). A history of cerebrovascular or periph- eral artery disease (PAD) also increases the likelihood of IHD. 2.1.3. Physical Examination The examination is often normal or nonspecific in patients with stable angina56 but could reveal related conditions such as heart failure, valvular heart disease, or hypertrophic cardiomyopathy. An audible rub suggests pericardial or Potential revascularization procedure warranted based on assessment of coexisting cardiac and noncardiac factors and patient preferences? Perform coronary angiography Yes Heart Team concludes that anatomy and clinical factors indicate revascularization may improve survival (Table 18) Determine optimal method of revascularization based upon patient preferences, anatomy, other clinical factors, and local resources and expertise (Table 18) Yes No No Noninvasive testing suggests high-risk coronary lesion(s) from Figure 2 Continued Guideline- Directed Medical Therapy with ongoing patient education Go to Figure 4 Guideline-Directed Medical Therapy continued in all patients Figure 5. 