Choosing Wisely:

Avoid using stress echocardiograms on asymptomatic patients who meet "low-risk" scoring criteria for coronary disease.

Rationale and Comments: Stress echocardiography is mostly used in symptomatic patients to assist in the diagnosis of obstructive coronary artery disease. There is very little information on using stress echocardiography in asymptomatic individuals for the purposes of cardiovascular risk assessment, as a stand-alone test or in addition to conventional risk factors.
Sponsoring Organizations:
  • American Society of Echocardiography
  • Sources:
  • ACC/AHA guidelines
  • Disciplines:
  • Cardiovascular
  • References: • Douglas PS, et al. ACCF/ASE/AHA/ASNC/HFSA/HRS/ SCAI/SCCM/SCCT/SCMR 2011 appropriate use criteria for echocardiography. J Am Soc Echocardiogr. 2011;24:229-67.
    • Gibbons RJ, et al. ACC/AHA 2002 guideline update for the management of patients with chronic stable angina. 2002. http://www.cardiosource.org/~/media/Images/ACC/Science%20and%20Quality/Practice%20Guidelines/s/stable_clean.ashx
    • Greenland P, et al. 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults. J Am Coll Cardiol. 2010;56:e50-103.

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