Читать книгу Practical Cardiovascular Medicine - Elias B. Hanna - Страница 193

Figure 3.2 Proposed diagnostic approach to chronic chest pain. Note that CTA has gained a central role in high CAD probability and high-risk patients, including high-risk stress test, thanks to ISCHEMIA trial. The main goal of CTA in high-risk patients is to rule out left main disease, in which case conservative management is acceptable. The only exception is CKD (GFR<60), wherein stress imaging is preferred for diagnosis, keeping in mind that even a high-risk result is appropriately managed conservatively with no angiographic assessment at all. The solid arrows indicate the preferred strategy.