Follow-up
Table 15. Noninvasive Testing in Known SIHD:
Asymptomatic (or Stable Symptoms)
Test
Exercise Status ECG Interpretable
Able* Unable Yes No
Exercise or pharmacological
stress with nuclear MPI, Echo,
or CMR at ≥2-y intervals
✔ ✔
Exercise ECG at ≥1-y intervals
✔ ✔
Exercise ECG
✔ ✔
Exercise or pharmacological
stress with nuclear MPI, Echo,
or CMR or CCTA
Any Any
* Patients are candidates for exercise testing if they are capable of performing at least moderate
physical functioning (ie, moderate household, yard, or recreational work and most activities of
daily living ) and have no disabling comorbidity. Patients should be able to achieve 85% of age-
predicted maximum heart rate.
Noninvasive Testing in Known SIHD— Asymptomatic
(or Stable Symptoms)
Î Nuclear MPI, echocardiography, or CMR with either exercise or
pharmacological stress can be useful for follow-up assessment at
≥2-year intervals in patients with SIHD with prior evidence of silent
ischemia or who are at high risk for a recurrent cardiac event and:
(IIa-C)
• are unable to exercise to an adequate workload,
• have an uninterpretable ECG, or
• have a history of incomplete coronary revascularization
Î Standard exercise ECG testing performed at ≥1-year intervals might be
considered for follow-up assessment in patients with SIHD who have
had prior evidence of silent ischemia or are at high risk for a recurrent
cardiac event and are able to exercise to an adequate workload and
have an interpretable ECG. (IIb-C)
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