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Table 123-1

Stress Testing Recommendations

SUBGROUPRECOMMENDED STUDY
Pt able to exercise
If baseline ST-T on ECG is normalStandard 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 (e.g., 99m Tc-sestamibi) or

Echocardiography

Pt not able to exercise (regardless of baseline ST-T abnormality)

Pharmacologic stress test (IV adenosine, regadenoson, dipyridamole, dobutamine) combined with imaging:

Perfusion scintigraphy (e.g., 99m Tc-sestamibi or PET [rubidium-82 or N-13 ammonia]) or

Echocardiography or

Cardiac MRI

LBBB on baseline ECGPharmacologic stress test with imaging