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Î CMR with pharmacological stress is reasonable for risk assessment in
patients with SIHD who are able to exercise to an adequate workload
but have an uninterpretable ECG. (IIa-B)
Î CCTA may be reasonable for risk assessment in patients with
SIHD who are able to exercise to an adequate workload but have an
uninterpretable ECG. (IIb-B)
Î Pharmacological stress imaging (nuclear MPI, echocardiography, or
CMR) or CCTA is NOT recommended for risk assessment in patients
with SIHD who are able to exercise to an adequate workload and have
an interpretable ECG. (III-C: No Benefit)
Risk Assessment In Patients Unable To Exercise
Î Pharmacological stress with either nuclear MPI or echocardiography
is recommended for risk assessment in patients with SIHD who
are unable to exercise to an adequate workload regardless of
interpretability of ECG. (I-B)
Î Pharmacological stress CMR is reasonable for risk assessment in
patients with SIHD who are unable to exercise to an adequate workload
regardless of interpretability of ECG. (IIa-B)
Î CCTA can be useful as a first-line test for risk assessment in patients
with SIHD who are unable to exercise to an adequate workload
regardless of interpretability of ECG. (IIa-C)
Risk Assessment Regardless Of Patients' Ability To Exercise
Î Pharmacological stress with either nuclear MPI or echocardiography
is recommended for risk assessment in patients with SIHD who
have LBBB on ECG, regardless of ability to exercise to an adequate
workload. (I-B)
Î Either exercise or pharmacological stress with imaging (nuclear MPI,
echocardiography, or CMR) is recommended for risk assessment in
patients with SIHD who are being considered for revascularization of
known coronary stenosis of unclear physiological significance. (I-B)
Î CCTA can be useful for risk assessment in patients with SIHD who
have an indeterminate result from functional testing. (IIa-C)
Î CCTA might be considered for risk assessment in patients with SIHD
unable to undergo stress imaging or as an alternative to invasive
coronary angiography when functional testing indicates a moderate-
to high-risk result and angiographic coronary anatomy is unknown.
(IIb-C)
ÎA request to perform either a) more than 1 stress imaging study or b) a
stress imaging study and a CCTA at the same time is NOT recommended
for risk assessment in patients with SIHD. (III-C: No Benefit)
