Do not perform an ischemia induction test in the follow-up of chronic coronary syndromes in the stable and asymptomatic patient.
In chronic coronary syndromes, with preserved left ventricular function, coronary revascularization aims to control symptoms and does not affect the prognosis. In stable and asymptomatic patients, ischemia research tests are not indicated and increase the risk of...
Don’t perfom Holter electrocardiographic monitoring in patients suffering from syncope, near syncope o dizziness, in whom a non arrhytmic origin has been documented
Holter monitoring is indicated if the likelyhood of arrhytmia causing a syncope is elevated. Monitoring devices should be choosen according to syncope frequency: Holter for daily symptoms, external loop recorder for weekly, and subcutaneous implantable device for...
Do not request stress testing for inducible ischemia.
It is not appropriate to use stress testing to diagnose obstructive coronary artery disease as a first-line test, as it has extremely limited diagnostic power in recognizing or excluding significant coronary artery disease. Stress testing may be considered for the...
Do not request annual follow-up echocardiography in patients with known mild-to-moderate valvular disease in the absence of new symptoms or clinical events and in patients with known mild left ventricular dysfunction in the absence of new symptoms or clinical events.
Since mild-moderate valvular disease generally has a slow progression, echocardiography should be performed more frequently only in the presence of changes in clinical status. Transthoracic echocardiography is indicated to investigate the appearance of new symptoms,...The campaign DOING MORE DOES NOT MEAN DOING BETTER – CHOOSING WISELY ITALY is promoted by Italy’s Slow Medicine
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