Non-invasive functional testing for possible myocardial ischaemia

Non-invasive functional testing for myocardial ischaemia:

Use of non-invasive functional testing for myocardial ischaemia

• when offering non-invasive functional imaging for myocardial ischaemia use:
  • myocardial perfusion scintigraphy with single photon emission computed tomography (MPS with SPECT) or
  • stress echocardiography or
  • first-pass contrast-enhanced magnetic resonance (MR) perfusion or
  • MR imaging for stress-induced wall motion abnormalities. Take account of locally available technology and expertise, the person and their preferences, and any contraindications when deciding on the imaging method
• use adenosine, dipyridamole or dobutamine as stress agents for MPS with SPECT and adenosine or dipyridamole for first-pass contrast-enhanced MR perfusion
• use exercise or dobutamine for stress echocardiography or MR imaging for stress-induced wall motion abnormalities
• do not use MR coronary angiography for diagnosing stable angina
• do not use exercise ECG to diagnose or exclude stable angina for people without known CAD

Reference:

• 1) NICE (March 2010). Chest pain of recent onset.