US Echocardiography Transesophageal There is no relevant literature to support the use of transesophageal echocardiography in the initial evaluation of patients with chronic chest pain and a high probability of CAD with known IHD. US Echocardiography Transthoracic Resting US echocardiography transthoracic resting provides assessment of ejection fraction and ventricular volumes such as LVEF and ESVI with a higher sensitivity to detect prior myocardial infarct than ischemia. Although there is no relevant literature evaluating the use transthoracic echocardiography resting in the initial evaluation of patients with Chronic Chest Pain-High Probability of CAD chronic chest pain and known IHD, this modality provides information about wall motion abnormality and left ventricular function which may inform next step management of patients with IHD. US Echocardiography Transthoracic Stress US stress 2-D echocardiography depiction of myocardial contractility during rest and stress is used for the evaluation of patients with suspected regional wall motion abnormalities secondary to inducible regional ischemia. The data cited below for US Echocardiography transthoracic stress are for patients with known CAD, but no information is available regarding the presence or absence of chest pain in patients included in those studies. In a meta-analysis of 435 patients (299 with and 136 without angiographically assessed CAD), dobutamine stress contractility echocardiography had 84% accuracy, 86% specificity, and 86% sensitivity for detecting CAD [71]. A meta-analysis of 44 studies including patients with suspected or known CAD indicated that stress echocardiography has a sensitivity of 85% and a specificity of 77% in detection of CAD (defined as >50% coronary artery luminal diameter stenosis) [72].
Chronic Chest Pain High Probability of Coronary Artery Disease PCAs. US Echocardiography Transesophageal There is no relevant literature to support the use of transesophageal echocardiography in the initial evaluation of patients with chronic chest pain and a high probability of CAD with known IHD. US Echocardiography Transthoracic Resting US echocardiography transthoracic resting provides assessment of ejection fraction and ventricular volumes such as LVEF and ESVI with a higher sensitivity to detect prior myocardial infarct than ischemia. Although there is no relevant literature evaluating the use transthoracic echocardiography resting in the initial evaluation of patients with Chronic Chest Pain-High Probability of CAD chronic chest pain and known IHD, this modality provides information about wall motion abnormality and left ventricular function which may inform next step management of patients with IHD. US Echocardiography Transthoracic Stress US stress 2-D echocardiography depiction of myocardial contractility during rest and stress is used for the evaluation of patients with suspected regional wall motion abnormalities secondary to inducible regional ischemia. The data cited below for US Echocardiography transthoracic stress are for patients with known CAD, but no information is available regarding the presence or absence of chest pain in patients included in those studies. In a meta-analysis of 435 patients (299 with and 136 without angiographically assessed CAD), dobutamine stress contractility echocardiography had 84% accuracy, 86% specificity, and 86% sensitivity for detecting CAD [71]. A meta-analysis of 44 studies including patients with suspected or known CAD indicated that stress echocardiography has a sensitivity of 85% and a specificity of 77% in detection of CAD (defined as >50% coronary artery luminal diameter stenosis) [72].