18
Diagnosis
Table 8. Using Stress Testing and Advanced Imaging for
Patients With Known SIHD Who Require Noninvasive
Testing for Risk Assessment
Test
Exercise Status ECG Interpretable
Able Unable Yes No
Patents able to exercise*
Exercise ECG
✔ ✔
Exercise with nuclear MPI or
Echo
✔ ✔
Exercise with nuclear MPI or
Echo
✔ ✔
Pharmacological stress CMR
✔ ✔
CCTA
✔ ✔
Pharmacological stress imaging
(nuclear MPI, Echo, CMR)
or CCTA
✔ ✔
Patients unable to exercise
Pharmacological stress with
nuclear MPI or Echo
✔
Any
Pharmacological CMR
✔
Any
CCTA
✔
Any
Regardless of patient's ability to exercise
Pharmacological stress with
nuclear MPI or Echo
Any
✔
Exercise/pharmacological
stress with nuclear MPI, Echo,
or CMR
Any Any
CCTA Any Any
CCTA Any Any
Requests to perform multiple
cardiac imaging or stress
studies at the same time
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.
