Exercise ECG |
widely available, does not require intravenous
access or radiation exposure, relatively inexpensive, widely validated |
some patients are unable to exercise, some may have certain baseline ECG
abnormalities that make the ECG uninterpretable during stress, certain
medications can cause false positive ST changes |
IIbB |
cardiovascular
mortality >3% per year according to Duke Treadmill
Score |
CT coronary angiography |
rich evidence, high accuracy,
identification and quantification of calcification and plaque volume |
usage of iodinated contrast material, exposure to radiation, lacks the
ability to predict the functional significance of stenoses |
IB |
three-vessel disease with proximal stenoses, LM disease, or proximal
anterior descending disease |
SPECT or PET perfusion imaging |
high image quality |
susceptible to technical and acquisition issues, use of ionizing
radiation, dependent on operator expertise, limited availability and a
relatively high cost |
IB |
area of ischaemia >=10% of the
left ventricle myocardium |
Stress echocardiography
|
versatile/patient-friendly, lack of ionizing radiation
Inexpensive
|
dependent on image quality due to body habitus or pulmonary disease,
technical challenges, operator dependent
|
IB
|
>=3 of 16 segments with stress-induced hypokinesia or
akinesia
|
Stress CMR
|
high resolution and reproducibility, identification of plaque ulceration
and intraplaque hemorrhage
|
expensive and low availability,
complex training required
|
IB
|
>=2 of 16 segments with stress perfusion defects or
>=3 dobutamine-induced dysfunctional segments
|