5 Features of non-invasive tests available for further risk stratification of patients with chest pain, after excluding acute myocardial infarction
Procedural considerations Relative contraindications*
Condition and test Cost† Radiation
Iodinated
contrast media
Inability to
exercise
Significant resting
ECG abnormality‡
Renal
impairment Obesity
Severe airway
disease
Myocardial ischaemia or perfusion
Exercise stress electrocardiography $ No No Yes Yes No Yes Yes§
Stress echocardiography $$ No No No¶ Yes No Yes No¶
Myocardial perfusion scanning $$$ Yes No No¶ No No Yes Yes§**
Obstructive coronary artery disease
Computed tomography coronary angiography $$ Yes Yes No No Yes Yes No
ECG=electrocardiogram. *Relative contraindications should be discussed further for individual patients. †Relative cost indications are based on current Medicare rebates. ‡ For
example, left bundle branch block. § If there is significant functional impairment. ¶ If pharmacological stress testing can be performed. **Adenosine is contraindicated. ◆