Risk stratification for coronary artery disease using pharmacological stress tests

Cardiac stress testing is frequently used for diagnosis of coronary artery disease and for risk stratification which can facilitate decision making and help in the overall management of patients with known or suspected coronary disease. Exercise remains the preferred stress modality and should be performed when feasible but it is often contraindicated, impractical or unable to provide the needed information. In these circumstances pharmacologic stress tests can provide a wealth of prognostic data and should be performed instead of non-diagnostic or suboptimal exercise stress tests. Here we will review the use of pharmacologic stress tests including the indications for ordering them and the different stress agents and imaging modalities that can be utilized with emphasis on practical information that the primary care physician and general practitioner need on a daily basis in their practice.