Do not request stress testing for inducible ischemia.

Do not request stress testing for inducible ischemia.

Type of practice

Cardiological tests

Age

Adult, Geriatric

Topic Area

Cardiology

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 diagnosis of obstructive coronary artery disease if imaging tests are not available.

Sources

1. Knuuti J, Ballo H, Juarez-Orozco LE, et al. The performance of non-invasive tests to rule-in and rule-out significant coronary artery stenosis in patients with stable angina: a meta-analysis focused on post-test disease probability. Eur Heart J 2018;39:3322-3330. doi: 10.1093/eurheartj/ehy267.
2. Zacharias K, Ahmed A, Shah BN, et al. Relative clinical and economic impact of exercise echocardiography vs. exercise electrocardiography, as first line investigation in patients without known coronary artery disease and new stable angina: a randomized prospective study. Eur Heart J Cardiovasc Imaging 2017;18:195-202. doi: 10.1093/ehjci/jew049.
3. Williams MC, Hunter A, Shah ASV, et al. Use of coronary computed tomographic angiography to guide management of patients with coronary disease. J Am Coll Cardiol 2016;67:1759-1768. doi: 10.1016/j.jacc.2016.02.026.

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Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.