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Don't perform stress cardiac imaging or coronary angiography in patients without cardiac symptoms unless high-risk markers are present. Setting: asymptomatic patient at low risk for coronary artery disease, without high-risk markers, being considered for screening cardiac imaging Why: Screening stress imaging in asymptomatic low-risk patients rarely changes management and leads to false positives, radiation, and invasive follow-up. Consider instead: risk-factor assessment and modification; test only symptomatic or high-risk patients Source: American College of Cardiology (Choosing Wisely, US, 2012).
Don't perform stress cardiac imaging or coronary angiography in patients without cardiac symptoms unless high-risk markers are present. Setting: asymptomatic patient at low risk for coronary artery disease, without high-risk markers, being considered for screening stress cardiac imaging or coronary angiography; does NOT apply to coronary artery calcium (CAC) scoring obtained to refine risk and guide statin decision-making in an intermediate-risk adult (2018 ACC/AHA cholesterol guideline) Why: Screening stress imaging in asymptomatic low-risk patients rarely changes management and leads to false positives, radiation, and invasive follow-up. Consider instead: risk-factor assessment and modification; test only symptomatic or high-risk patients Source: American College of Cardiology (Choosing Wisely, US, 2012).