Non-invasive imaging in coronary syndromes: recommendations of the European Association of Cardiovascular Imaging and the American Society of Echocardiography, in collaboration with the American Society of Nuclear Cardiology, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance
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Stress echocardiography allows combined assessment of ischaemia with diastolic function, valvular structure and function, presence of LV hypertrophy, atrial enlargement, RV size and function, and pulmonary hypertension
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- Anatomical or functional imaging should be used as first-line test for diagnostic and prognostic purposes in patients with known or suspected CAD and low to high PTP.
- Myocardial ischaemia can be detected by stress-induced perfusion defects or WMA.
- Echocardiography, SPECT, PET, CMR, and CT-FFR can detect ischaemia with high accuracy.
- The choice of one test over the other will depend on relative contraindications, patient characteristics, and local availability and expertise.
- With all techniques, the presence of ischaemia, as well as its location, extent, and severity should be reported as they all have diagnostic and prognostic value