Risk Strat. - Non-Inv / Inv Testing

Question 1

Asymptomatic Adults

No Known IHD

• Class 1 Indications

Answer 1

Question 2

Framingham Risk Groups

Answer 2

Question 3

CHD Risk Equivalents

(ATP III)

Answer 3

Question 4

Asymptomatic Adult

New Pooled Cohort Equations (ACC/AHA)

Answer 4

Question 5

Asymptomatic Adult

Added Value for Risk Assessment?

Answer 5

Question 6

Coronary Calcium Scoring (CACS)

Reclassifying Intermediate Risk Patients

Answer 6

Question 7

Asymptomatic Adults

Any role for Stress Imaging?

Answer 7

Question 8

Classification of Stable Angina

Answer 8

Question 9

Pretest Probability of CAD

Incorporating Risk Factor Data

Answer 9

Question 10

Stress Testing / Advanced Imaging for

Initial Diagnosis in Patients with

Suspected IHD

• Key Points

Answer 10

Question 11

Stress Testing / Advanced Imaging for Initial Diagnosis in Patients with Suspected IHD

Pretest Probability: LOW

Exercise: Able

ECG: Interpretable

Answer 11

Question 12

Stress Testing / Advanced Imaging for Initial Diagnosis in Patients with Suspected IHD

Pretest Probability: INTERMEDIATE (TO HIGH)

Exercise: Able

ECG: Interpretable

Answer 12

Question 13

Stress Testing / Advanced Imaging for Initial Diagnosis in Patients with Suspected IHD

Pretest Probability: INTERMEDIATE (TO HIGH)

Exercise: Able

ECG: UNInterpretable

Answer 13

Question 14

Stress Testing / Advanced Imaging for Initial Diagnosis in Patients with Suspected IHD

Pretest Probability: LOW

Exercise: UNable

Answer 14

Question 15

Stress Testing / Advanced Imaging for Initial Diagnosis in Patients with KNOWN SIHD

SIHD

Exercise: Able

ECG: Interpretable

Answer 15

Question 16

Uninterpretable ECG

Answer 16

Question 17

Exercise ECG

High Risk Findings

Answer 17

Question 18

Duke Treadmill Score

Equation & Risk Groups

Answer 18

Question 19

Duke Treadill Score

4-yr CV Survival

Average Annual CV Mortality Rate

Answer 19

Question 20

Duke Treadmill Score

Treatment Based on Risk

Answer 20

Question 21

Stress Testing / Advanced Imaging for Initial Diagnosis in Patients with Suspected SIHD

SIHD

Exercise: Able

ECG: UNInterpretable

Answer 21

Question 22

Stress Testing / Advanced Imaging for Initial Diagnosis in Patients with Suspected SIHD

SIHD

Exercise: UNable

Answer 22

Question 23

Stress Testing / Advanced Imaging for Initial Diagnosis in Patients with Suspected SIHD

SIHD

Exercise: Regardless

ECG: LBBB

Answer 23

Question 24

Stress Testing / Advanced Imaging for Initial Diagnosis in Patients with Suspected SIHD

SIHD

• Change in symptoms and prior revascularization

or

• Coronary stenosis of unclear physiologic significance

Answer 24

Question 25

Low Risk Imaging Findings \< 1% Annual Cardiac Death or MI

Answer 25

Question 26

Intermediate Risk Findings 1-3% Annual Cardiac Death or MI

Answer 26

Question 27

High Risk Imaging Findings \>3% Annual Cardiac Death or MI

Answer 27

Question 28

Patients with SIHD Resting Imaging Known or Suspected SIHD to assess LV function, valves and pericardium

Answer 28

Question 29

Coronary Angiography as INITIAL testing strategy to assess risk

Answer 29

Question 30

Coronary Angiography to Assess Risk after Initial workup with Noninvasive Testing (NIT)

Answer 30

Question 31

Follow-up of Patients with SIHD

Answer 31

Question 32

Follow-up of Patients with SIHD Asymptomatic or Stable Symptoms

Answer 32

Question 33

Stress Test with LBBB

Answer 33

Question 34

Patients with SIHD Resting Imaging