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...
Don’t perform exercise stress test as screening of ischemic heart disease in asymptomatic patients at low cardiovascular risk
In asymptomatic patients without risk factors, the likelihood of coronary heart disease is very low. The stress test increases risk of false positives and induces further diagnostic tests to rule out the doubts raised by the test.
Don’t perform 24 hour Holter monitoring in patients with effort chest pain who can perform exercise stress test, unless arrhythmias should be investigated.
Since during Holter monitoring the amount of stress could not be calibrated, sensitivity and specificity for detecting ischemia in patients with chest pain are low. In these conditions stress test is superior.The campaign DOING MORE DOES NOT MEAN DOING BETTER – CHOOSING WISELY ITALY is promoted by Italy’s Slow Medicine
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