Sn 80% sp 84%
When used in low-risk patients, NPV 97-100%
When used in low-risk patients, NPV 97-100%
Who should be tested (ACC/AHA Class IIa)
patients with abnormal baseline ECG
patients unable to exercise
women with low- to intermediate-risk
patients with abnormal baseline ECG
patients unable to exercise
women with low- to intermediate-risk
Who shouldn’t be tested with<unk>  echo
patients in whom a sub-optimal study is likely (very obese, COPD with expanded AP chest diameter, etc)
patients with grossly abnormal baseline LV or valvular function (e.g. severe AS)
patients in whom a sub-optimal study is likely (very obese, COPD with expanded AP chest diameter, etc)
patients with grossly abnormal baseline LV or valvular function (e.g. severe AS)

The Bottom Line<unk>  echocardiography (chemical or exercise induced) has greater sensitivity and specificity than ETT for<unk>  (especially for women)
Patients with normal<unk>  echos are at very low risk for mortality within 1 year
A normal<unk>  echo does not preclude subsequent<unk> , nor should it lower suspicion for<unk>  when a patient presents with new symptoms!<unk>  echocardiography (chemical or exercise induced) has greater sensitivity and specificity than ETT for<unk>  (especially for women)
Patients with normal<unk>  echos are at very low risk for mortality within 1 year
A normal<unk>  echo does not preclude subsequent<unk> , nor should it lower suspicion for<unk>  when a patient presents with new symptoms!
ACS - Stress Testing
Harbor Macros: EKG
ACS - Risk Stratification
Unstable Angina - NSTEMI Guidelines
Age adjusted D-dimer
ECGs by Diagnosis
Bubble study
ADDIE system