Cardiovascular Medicine Book

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Cardiac Stress Imaging Indications

Aka: Cardiac Stress Imaging Indications, Stress Imaging Indications, Stress EKG with Cardiac Imaging Indications, Stress Electrocardiogram with Imaging Indications
  1. Indications: Symptomatic Patients
    1. Intermediate to high risk for Coronary Artery Disease OR
    2. Known Coronary Artery Disease with prior revascularization OR
    3. High risk of false positive testing or uninterpretable EKG (see below)
  2. Indications: False positive likely on Exercise Stress Test
    1. Medication Use
      1. Digoxin
      2. Type I Antiarrhythmic
    2. WPW Syndrome
    3. Left Ventricular Hypertrophy
      1. Especially with "strain" pattern
    4. Significant valvular disease
    5. Severe Hypertension
    6. Hypertrophic Cardiomyopathy
    7. Mitral Valve Prolapse
    8. Baseline ST-T Wave abnormality
    9. Female gender
      1. Exercise Stress Test is now recommended as first-line test instead
  3. Indications: Stress EKG not interpretable
    1. Left Bundle Branch Block (including rate dependent blocks)
    2. Pacemaker dependency
    3. Baseline ST abnormality (>1 mm)
    4. Baseline T Wave abnormalities
  4. Indications: Precise anatomic information desired
    1. Correlation with catheterization findings
    2. Follow-up revascularization procedures
  5. References
    1. Garner (2017) Am Fam Physician 96(5): 293-9 [PubMed]

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