19
Favors use of CCTA Favors use of stress imaging
• Rule out obstructive CAD
• Detect nonobstructive CAD
• Ischemia-guided
management
• High-quality imaging and
expert interpretation
routinely available
• High-quality imaging and
expert interpretation
routinely available
• Age <65 y • Age ≥65 y
• Prior functional study
inconclusive
• Prior CCTA inconclusive
• Anomalous coronary arteries
• Require evaluation of aorta
or pulmonary arteries
• Suspect scar (especially if
PET or stress CMR available)
• Suspect coronary
microvascular dysfunction
(when PET or CMR available)
Option for CAC for ASCVD
risk stratification
Less obstructive
CAD suspected
CCTA favored
More obstructive
CAD suspected
Stress testing favored
OR
OR
ETT
Stress
echocardiography
SPECT
MPI
PET MPI
Stress CMR
MPI
✔ ✔ ✔
✔ ✔ ✔ ✔
✔ ✔
✔ ✔ ✔ ✔
