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Optimize your use of stress tests: a Q&A guide
1UPMC Shadyside Family Medicine Residency, Pittsburgh, PA, USA. knoxma@upmc.edu
Abstract:
Order exercise stress testing without imaging for patients with a low to intermediate probability of coronary artery disease (CAD), unless preexisting electrocardiographic (EKG) changes would render such a test nondiagnostic. Order stress testing with imaging for patients with preexisting EKG changes and/or a high probability of CAD. Do not use stress testing to screen asymptomatic patients for CAD. Consider pharmacologic testing for patients who are unable to exercise to an appropriate cardiac workload; it has the same predictive value as a nuclear exercise stress test.
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