What is pharmacological stress echocardiography used for in patients with a low pretest probability of ischemic heart disease?
Pharmacological stress echocardiography is recommended for patients with a low pretest probability of ischemic heart disease (IHD) as an initial diagnosis test. This test involves exercising with nuclear myocardial perfusion imaging (MPI) or echocardiography (Echo), or using cardiac computed tomography angiography (CCTA) to evaluate for IHD. This test is classified as Class I, Level of Evidence (LOE) B, according to the American College of Cardiology/American Heart Association guidelines. It is also recommended to use pharmacological stress with nuclear MPI or Echo if the patient is unable to exercise, and this test is classified as Class IIa, LOE B. Exercise stress with nuclear MPI is classified as Class III, LOE C, and is not recommended. 