ABSTRACT
Exercise stress testing, stress echocardiography (SE), and myocardial perfusion scintigraphy are frequently used for the evaluation for patients with known or suspected ischemic heart disease (1). First, these techniques provide important information that is invaluable for the diagnosis of coronary artery disease (CAD). Second, they are useful in evaluating the effect of therapy in patients with CAD. Finally, stress testing provides important prognostic information that can be used to identify low-risk and high-risk patient subsets and guide clinical management (2). This chapter describes pathophysiological aspects of CAD that can be probed with stress testing. The methodology and the practical aspects of exercise stress testing, SE, and myocardial perfusion scintigraphy are described. The diagnostic accuracy of the various stress testing modalities for evaluation of CAD is discussed. The prognostic value and risk stratifi cation are addressed. Subsequently, the advantages and limitations of the various stress testing modalities are discussed and a scheme for appropriate clinical application of these modalities is proposed.
