Those without recurrent ischemia, significant arrhythmias, pul- monary edema, or hemodynamic instability can be considered for admission or transfer to an intermediate care or telemetry unit. An assessment of LV function is recommended because depressed LV function will likely influence pharmacological therapies (eg, angiotensin-converting enzyme [ACE] inhibitors for depressed left ventricular ejection fraction [LVEF]), may sug- gest the presence of more extensive CAD, and may influence the choice of revascularization (PCI versus coronary artery bypass graft surgery [CABG]). Because significant valvular disease may also influence the type of revascularization, echocardiography rather than ventriculography is often preferred for assessment of LV function. 4.1. Standard Medical Therapies. See Table 6 for a summary of recommendations from this section. 4.1.1. Oxygen: Recommendation Class I 1. Supplemental oxygen should be administered to pa- tients with NSTE-ACS with arterial oxygen satura- tion less than 90%, respiratory distress, or other high- risk features of hypoxemia. (Level of Evidence: C) Patients with cyanosis, arterial oxygen saturation <90%, respira- tory distress, or other high-risk features of hypoxemia are treated with supplemental oxygen. The 2007 UA/NSTEMI CPG recom- mended the routine administration of supplemental oxygen to all patients with NSTE-ACS during the first 6 hours after presenta- tion on the premise that it is safe and may alleviate hypoxemia.212 The benefit of routine supplemental oxygen administration in normoxicpatientswithNSTE-ACShasneverbeendemonstrated. At the time of GWC deliberations, data emerged that routine use of supplemental oxygen in cardiac patients may have untoward effects, including increased coronary vascular resistance, reduced coronary blood flow, and increased risk of mortality.213 215 4.1.2. Anti-Ischemic and Analgesic Medications 4.1.2.1. Nitrates: Recommendations Class I 1. Patients with NSTE-ACS with continuing ischemic pain should receive sublingual nitroglycerin (0.3 mg Table 6. 