Stress Testing Recommendations
| Subgroup | Recommended Study |
|---|---|
| Pt able to exercise | |
| If baseline ST-T on ECG is normal | Standard exercise test (treadmill, bicycle, or arm ergometry) |
| If baseline ST-T impairs test interpretation (e.g., LVH with strain, digoxin) | Standard exercise test (above) combined with either Perfusion scintigraphy (thallium-201, 99mTc-sestamibi) or |
| Echocardiography | |
| Pt not able to exercise (regardless of baseline ST-T abnormality) | Pharmacologic stress test (IV dobutamine, dipyridamole, or adenosine) combined with imaging: |
| Perfusion scintigraphy [thallium 201, 99mTc-sestamibi, or PET (rubidium-82 or N-13 ammonia)] or | |
| Echocardiography or | |
| Cardiac MRI | |
| LBBB on baseline ECG | Adenosine (or dipyridamole) 99mTc-sestamibi or PET scintigraphy |