Don’t perform stress cardiovascular magnetic resonance (CMR) in the initial evaluation of chest pain patients with low pretest probability of coronary artery disease.

Rationale and Comments

There are lower cost stress tests available for the initial evaluation of low-risk chest pain patients, particularly when they have a normal electrocardiogram and can exercise. Stress CMR can be valuable in evaluating intermediate-risk patients with abnormal electrocardiograms or who cannot exercise, or when initial test results are equivocal.

Sponsoring Organizations

Society for Cardiovascular Magnetic Resonance

Sources

American College of Radiology Appropriateness Criteria

Disciplines

Cardiovascular

References

Hendel RC, Patel MR, Kramer CM, Poon M, Hendel RC, Carr JC, Gerstad NA, Gillam LD, Hodgson JM, Kim RJ, Kramer CM, Lesser JR, Martin ET, Messer JV, Redberg RF, Rubin GD, Rumsfeld JS, Taylor AJ, Weigold WG, Woodard PK, Brindis RG, Hendel RC, Douglas PS, Peterson ED, Wolk MJ, Allen JM, Patel MR. ACCF/ACR/SCCT/SCMR/ASNC/NASCI/SCAI/SIR 2006 appropriateness criteria for cardiac computed tomography and cardiac magnetic resonance imaging. J Am Coll Cardiol. 2006 Oct 3;48(7):1475–97.
American College of Radiology; Society of Cardiovascular Computed Tomography; Society for Cardiovascular Magnetic Resonance; American Society of Nuclear Cardiology; North American Society for Cardiac Imaging; Society for Cardiovascular Angiography and Interventions; Society of Interventional Radiology. ACCF/ACR/SCCT/SCMR/ASNC/NASCI/SCAI/SIR 2006 appropriateness criteria for cardiac computed tomography and cardiac magnetic resonance imaging. J Am Coll Radiol. 2006 Oct;3(10):751–71.
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