For Referring Physicians

Appropriate

  • Acute Chest pain- Intermediate pre-test probability
  • No ST-elevation/cardiac enzymes
  • Chest Pain syndrome
  • Stress test uninterpretable or equivocal
  • EKG uninterpretable OR unable to exercise
  • Coronary anomaly or congenital heart disease
  • New CHF for possible CAD
  • R/O Aortic dissection or thoracic aneurysm
  • Electrophysiology
  • Pulmonary vein anatomy
  • Coronary vein anatomy
  • Cardiac mass or pericardial disease
  • Technically poor echo, MRI or TEE

Possibly Appropriate

  • Acute pain syndrome
  • Low or High pre-test probability
  • "Triple R/O"
  • Chest pain syndrome
  • Intermediate probability - EKG interpretable AND able to exercise
  • Prior CABG
  • Prior stents
  • Asymptomatic
  • CTA - High Framingham risk
  • Calcium score - High or Inter Framingham risk
  • Preop - High or inter risk surgery
  • Intermediate peri-op risk
  • LV function or Heart valve evaluation
  • Technically poor echo, MRI or TEE

Inappropriate

  • Acute chest pain - High pre-test probability
  • EKG ST - elevation or positive cardiac enzymes
  • Chest pain syndrome
  • High pre-test probability
  • Positive stress test - moderate to severe
  • Pre-op CTA - Low risk surgery
  • Asymptomatic - for CTA
  • Moderate or Low Framingham risk
  • Prior CABG
  • Prior stents
  • Asymptomatic - for calcium score
  • Low Framingham risk
  • Prior within 5 years
  • Normal cath within 2 years
  • Prior score ≥400