Ischemic Heart disease: coronary artery disease

Please choose the clinical evaluation:

• Patients in whom coronary artery disease (CAD) is suspected:
  - Pre-test probability of CAD 15-65% with LVEF >50% and stress ECG not possible due to physical limitations or an inconclusive stress ECG or in patients with ECG characteristics such as LBBB which lead to non-interpretable stress ECG.
  - Pre-test probability 66-85% for CAD or LVEF <50% without typical angina.
• Patients with known CAD diagnosed by an anatomical imaging modality in whom the functional significance of the stenosis should be determined.
• Patients with persistent symptoms after revascularization procedures.
• Patients with suspected CAD and an Agatston calcium score >400
• Pre- operative testing is recommended in the case of high-risk surgery in patients with poor functional capacity ( < 4 METS) and more than two clinical risk factors (ischemic heart disease (AP or previous MI), heart failure, stroke or TIA, renal dysfunction with creatinine clearance < 60 ml/mn, diabetes mellitus requiring insulin therapy), but may also be considered in patients with fewer than three of these risk factors.. A similar recommendation is made for intermediate-risk surgery patients, although no data from randomized trials are available.
• To assess viability of dysfunctional myocardium, sometimes followed by viability testing with FDG. In patients with heart failure and CAD before revascularisation.
  Secondary PCI, i.e. patients presenting late after infarction.
  Before treatment of chronic total occlusion (CTO).
• To exclude ischemia as a trigger for rhythm disorders.