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A 50 year old male smoker, with no significant past medical history, presents after a 45 minute episode of chest pain.
Describe at least five features of the clinical history that would increase the probability of a diagnosis of acute myocardial infarction (AMI).
What test results would indicate a high probability that this patient has AMI?
His pain radiates to both arms, was precipitated by exercise and relieved by rest. He also reports a strong family history of coronary heart disease. However, his ECG and cardiac markers are normal. Would an exercise treadmill test be useful to rule out coronary heart disease?