Optimize your use of stress tests: a Q&A guide

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.