Don’t perform stress cardiac imaging or coronary angiography in patients without cardiac symptoms unless high-risk markers are present.

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.

 

Sources:

Hendel RC, et al. The role of radionuclide myocardial perfusion imaging for asymptomatic individuals. J Nucl Cardiol. 2011 Feb;18(1):3-15. PMID: 21181519.

Hendel RC, et al. ACCF/ASNC/ACR/AHA/ASE/SCCT/SCMR/SNM 2009 Appropriate Use Criteria for Cardiac Radionuclide Imaging. J Am Coll Cardiol. 2009 Jun 9;53(23):2201-29. PMID: 19497454.