Appropriateness of Stress Echocardiography in a Patient with a Prior Stress Imaging or Coronary Angiogram Test Result

A stress echocardiography exam may or may not be appropriate for a patient with a prior stress imaging or coronary angiogram test result.

Patient selection: prior stress imaging or coronary angiogram test result

Parameters:

(1) findings on prior exam

(2) current symptoms

(3) time of last exam

(4) global coronary artery disease risk

Prior Exam	Current Symptoms	Time of Last Exam	CAD Risk	Evaluation
normal	new or worse	NA	NA	uncertain
normal	unchanged	< 2 years	NA	not appropriate
normal	unchanged	>= 2 years	low	not appropriate
normal	unchanged	>= 2 years	intermediate or high	uncertain
equivocal, borderline, discordant	NA	NA	NA	appropriate
abnormal	new or worse	NA	NA	appropriate
abnormal	unchanged	< 2 years	NA	not appropriate
abnormal	unchanged	>= 2 years	NA	uncertain

If the appropriateness is uncertain, then additional clinical findings may be needed to decide whether or not to proceed with the study.

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