ABSTRACT
Coronary artery disease (CAD) is one of the leading causes
of death and disability in the industrialized world. Invasive
coronary angiography is considered the diagnostic standard
for establishing the presence and severity of significant
CAD. However, interventional treatment is generally per-
formed in no more than 50% of diagnostic procedures. As
invasive procedures have an associated mortality (0.15%)
and morbidity (1.5%),1 attention has been turned to finding
accurate noninvasive diagnostic tests. Noninvasive imaging
testing for the detection of CAD has evolved significantly
over the last 50 years. From resting ECG, to stress ECG, and
stress echocardiography and nuclear imaging tests, we have
gradually improved our ability to detect CAD. Stress testing
is useful to establish prognosis in patients with suspected
coronary artery disease but has limited diagnostic utility.2 In
the best circumstances, the accuracy of stress imaging tests is
<85% for the detection of obstructive disease and negligible
for the detection of non-obstructive CAD.
