Stress Testing for Diagnosis of Coronary Artery Disease

Stress Testing for Diagnosis of Coronary Artery Disease
Pretest probability calculator/decision tool
[select name="gender" value="Female=10|Male=100"] <-- Gender
[select name="age" value="30 to 39=1|40 to 49=2|50 to 59=3|60 to 69=4"] <-- Age
[select name="pain" value="One Feature=10|Two Features=20|Three Features=30"] <-- Pain has how many of the following features:
- A - Substernal location
- B - Provoked by exertion or stress
- C - Relieved by rest or nitroglycerin

Pretest probability --> [calc memo="pretest probability" value="score=((gender)*(pain))+(age);score>3003?'94%':score>3002?'93%':score>3001?'87%':score>3000?'76%':score>2003?'72%':score>2002?'65%':score>2001?'51%':score>2000?'34%':score>1003?'27%':score>1002?'20%':score>1001?'13%':score>1000?'4%':score>303?'86%':score>302?'73%':score>301?'55%':score>300?'26%':score>203?'51%':score>202?'31%':score>201?'22%':score>200?'12%':score>103?'14%':score>102?'7%':score>101?'3%':'2%'"]
Interpretation and recommendations:
One approach to pretest probability is to consider <20% low, 20-80% intermediate, and >80% high.
Based on your interpretation of pretest probability levels above, consider:
For high pretest probability:  exercise stress test may be performed to aid with prognosis and management.
For intermediate pretest probability:  exercise stress test may be performed to aid with diagnosis.
For low pretest probability:  exercise stress test may have a role in some circumstances, but is not generally recommended.

[checkbox memo="References (Hide/Show)" name="footnotes" value=""][conditional field="footnotes" condition="(footnotes).isNot('')"]References:
[link memo="#1" url="http://www.uptodate.com"] Garber, AM. Stress testing for the diagnosis of obstructive coronary heart disease. UpToDate, Basow, DS (Ed), UpToDate, Waltham, MA, 2015.  Accessed Jan 14 2017.
[link memo="#2" url="https://www.ncbi.nlm.nih.gov/pubmed/449990"] Weiner DA, Ryan TJ, McCabe CH, Kennedy JW, Schloss M, Tristani F, Chaitman BR, Fisher LD. Exercise stress testing. Correlations among history of angina, ST-segment response and prevalence of coronary-artery disease in the Coronary Artery Surgery Study (CASS). N Engl J Med. 1979 Aug 2;301(5):230-5.[/conditional]