Asymptomatic, low-risk patients account for up to 45% of inappropriate stress testing. Testing in these asymptomatic patients should be performed only when the following findings are present: diabetes in patients older than 40 years of age, peripheral arterial disease, and greater than 2% yearly coronary heart disease event rate.

Conditions: Asymptomatic Patients, Low Cardiac Risk

Diagnostic Tests: Stress Cardiac Imaging (Stress Nuclear, Stress MIBI), Thallium Scan

Procedures: Coronary Angiogram (Coronary Angiography), Catheter

Tools: Framingham Risk Calculator, Diamond & Forrester Chest Pain Cardiac Risk Calculator

Sources

• Hendel RC, Abbott BG, Bateman TM, Blankstein R, Calnon DA, Leppo JA, et al. The role of radionuclide myocardial perfusion imaging for asymptomatic individuals. J Nucl Cardiol. 2011 Feb;18(1):3-15. (PubMed)
• Hendel RC, Berman DS, Di Carli MF, Heidenreich PA, Henkin RE, Pellikka PA, et al. ACCF/ASNC/ACR/AHA/ASE/SCCT/SCMR/SNM 2009 Appropriate Use Criteria for Cardiac Radionuclide Imaging: A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the American Society of Nuclear Cardiology, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the Society of Cardiovascular Computed Tomography, the Society for Cardiovascular Magnetic Resonance, and the Society of Nuclear Medicine. J Am Coll Cardiol. 2009 Jun 9;53(23):2201-29. (PubMed)