57 of 57 terms · click a term for the full definition and its source
▦ All57 ◧ Ratings6 ♥ Disease and risk7 ◔ Symptoms5 ↺ Prior results14 ◆ Established CAD4 ≈ Other conditions6 ✚ Before surgery9 ◉ PET and FFR-CT4 ⚑ Feasibility2
Ratings Appropriate (A) Appropriate, median score 7 to 9: An appropriate option for management of patients in this population because benefits… Read more → Ratings May Be Appropriate (M) May Be Appropriate, median score 4 to 6: At times, an appropriate option for management of patients in this population… Read more → Ratings No data No in-scope document rates the combination and no defensible inference exists. The absence of a rating is not a… Read more → paraphrased Ratings Not applicable (grayed-out cell) The source document deliberately did not rate the modality for that scenario, most often because it is the test that… Read more → paraphrased Ratings Not specified by the AUCs The existing AUCs do not cover this combination. For example, the 2023 AUC rates patients with prior MI or… Read more → paraphrased Ratings Rarely Appropriate (R) Rarely Appropriate, median score 1 to 3: Rarely an appropriate option for management of patients in this population due… Read more → Disease and risk 10-year ASCVD risk Estimated with a calculator validated for the population; the ACC ASCVD Risk Estimator is recommended for North… Read more → paraphrased Disease and risk Chronic coronary disease (CCD) CCD: Diseases of the heart related to current or prior myocardial ischemia in a stable phase, including history of… Read more → Disease and risk Clinical ASCVD Clinical ASCVD is defined by a history of acute coronary syndrome; stable angina; coronary or other arterial… Read more → Disease and risk CV risk factors (Table 1.1) CV risk factors: diabetes mellitus, smoking, family history of premature CAD, hypertension, dyslipidemia. Read more → Disease and risk Known CAD (chest pain guideline usage) In this guideline, we revise the term known CAD to include patients with prior anatomic testing (invasive angiography… Read more → Disease and risk Known CCD as used in this tool For the symptomatic branch, "known CCD" follows the 2023 AUC's Table 1.3 heading: prior myocardial infarction or prior… Read more → paraphrased Disease and risk Risk-enhancing factors (Table C) Family history of premature ASCVD; primary hypercholesterolemia; metabolic syndrome; chronic kidney disease; chronic… Read more → paraphrased Symptoms Less-likely anginal symptoms Less-likely anginal symptoms: Symptoms including dyspnea or fatigue when not exertional and not relieved by… Read more → Symptoms Likely anginal symptoms Likely anginal symptoms: Chest/epigastric/shoulder/arm/jaw pain, chest pressure/discomfort, when occurring with… Read more → Symptoms Noncardiac explanation Noncardiac explanation: An alternative diagnosis, such as gastroesophageal reflux, chest trauma, anemia, chronic… Read more → Symptoms Similar to prior ischemic episode Similar to prior ischemic episode: Patients who are presenting with symptoms that are similar in character to those… Read more → Symptoms Why "atypical angina" is not used Chest pain should not be described as atypical, because it is not helpful in determining the cause and can be… Read more → Prior results Abnormal resting ECG Abnormal ECG: An ECG with findings concerning for ischemia or prior infarction such as resting ST-segment depression or… Read more → Prior results CAC-DRS Coronary artery calcium data and reporting system (CAC-DRS): A standardized reporting system to report the degree and… Read more → Prior results CAD-RADS Coronary artery disease-reporting and data system (CAD-RADS): A standardized reporting system to provide greater… Read more → Prior results Duke treadmill score DTS is calculated as follows: (number of minutes of Bruce protocol exercise time) – (5 x mm of ST segment deviation… Read more → Prior results Inconclusive exercise treadmill test Inconclusive exercise treadmill test: An exercise stress test that does not provide a sufficient level of confidence… Read more → Prior results Inconclusive stress imaging Inconclusive stress imaging: A SPECT, PET, echo, or CMR imaging stress study that does not provide adequate or reliable… Read more → Prior results Invasive angiography result categories Mild or none: maximal diameter stenosis 0–39%. Intermediate: 40–69%. Obstructive: ≥70%, or left main ≥50%. Read more → paraphrased Prior results Invasive physiological testing The results of coronary physiological testing are generally reported as continuous variables (ranging from 0-1).… Read more → Prior results Mild ischemia Mild ischemia: Ischemia is present but affects <10% of the myocardium on stress nuclear imaging, <4 of 32 subsegments… Read more → Prior results Moderate to severe ischemia Moderate to severe ischemia has been defined as an estimate of ≥5% annual risk of cardiac death or nonfatal MI. This… Read more → Prior results Normal exercise treadmill test Normal exercise treadmill test: Adequate exertional effort with no evidence of ischemia and no reproduction of symptoms. Read more → Prior results Normal stress imaging Normal stress imaging: No evidence of ischemia or infarction. Read more → Prior results Prior testing (sequential testing) Refers to sequential testing being done as part of a continued patient evaluation or application of recent testing… Read more → Prior results Warranty period of a normal test Normal coronary angiogram or CCTA without plaque: 2 years. Normal stress test with adequate stress: 1 year. Read more → paraphrased Established CAD High risk for, or history of, silent ischemia Diabetes mellitus with accelerated progression of CAD, chronic kidney disease, peripheral artery disease, prior… Read more → Established CAD Incomplete revascularization Incomplete revascularization: Coronary revascularization by percutaneous coronary intervention (PCI) or coronary artery… Read more → Established CAD Prior high-risk PCI Prior high-risk PCI: Revascularization posing a higher-than-normal risk for restenosis or closure (eg, PCI of a… Read more → Established CAD Routine or surveillance testing Clinical scenarios that describe routine or surveillance imaging imply that the test is being considered solely because… Read more → Other conditions Frequent PVCs Frequent premature ventricular contractions (PVCs): More than 30 PVCs per hour. Read more → Other conditions Heart failure (Table 2.4) Heart failure: Stages B, C, and D heart failure, as defined by the ACCF/AHA Guideline for the Management of Heart… Read more → Other conditions Infrequent PVCs Infrequent PVCs: Thirty or fewer PVCs per hour. Read more → Other conditions Nonsustained ventricular tachycardia Nonsustained VT: Cardiac arrhythmia of ≥3 consecutive complexes originating in the ventricles at a rate >100 beats/min… Read more → Other conditions Sustained ventricular tachycardia Cardiac arrhythmia of consecutive complexes originating in the ventricles at a rate >100 beats/min (cycle length: <600… Read more → Other conditions Syncope Syncope: A symptom that presents with an abrupt, transient, complete loss of consciousness, associated with inability… Read more → Before surgery Functional capacity (METs) Patients able to comfortably engage in physical activities of moderate intensity (eg, 4-7 METs) are generally not frail… Read more → Before surgery Known or suspected heart disease Represents ischemic heart disease, VHD, or HF. Any of the conditions mentioned in Definition 14 are present. There may… Read more → Before surgery Moderate or greater ischemia (pre-operative, Table B) the following definitions were based on the extent of modality specific ischemia that predicts a 4% to 6% annual risk… Read more → Before surgery No known or suspected heart disease Heart disease is not suspected based on history of no prior cardiac event, lack of cardiac risk factors, or prior… Read more → Before surgery Nonemergent, nonurgent surgery This document addresses the use of multimodality imaging for evaluation of patients undergoing nonurgent, nonemergent… Read more → Before surgery Normal stress testing (pre-operative) No evidence of ischemia by any of the following stress modalities: ECG only exercise stress test, exercise or… Read more → Before surgery Prior testing within 90 to 220 days The 90 to 220 days is meant to encompass the period of initial testing and any follow-up testing done to clarify a… Read more → Before surgery Surgical procedure risk Low, intermediate and high risk for vascular and nonvascular procedures are assigned from Table A of the 2024 AUC (for… Read more → paraphrased Before surgery Symptomatic / asymptomatic (pre-operative) A patient is deemed to be symptomatic when he/she exhibits typical signs and/or symptoms (eg, for congestive HF,… Read more → PET and FFR-CT Coronary microvascular dysfunction / microvascular angina According to COVADIS, the criteria for diagnosing micro- vascular angina pectoris requires the presence of (1) symptoms… Read more → PET and FFR-CT CT-derived fractional flow reserve (FFR-CT) CT-FFR is recommended for the assessment of coronary artery diameter stenosis of 50–90%. CT-FFR should be performed… Read more → PET and FFR-CT Exercise PET The physical 110-minute half-life of 18F allows the use of 18F-Flurpiridaz both with exercise and pharmacologic stress… Read more → PET and FFR-CT Myocardial blood flow and flow reserve (PET) The assessment of hyperemic MBF and MFR (MFR 5 MBF during hyperemia/MBF at rest), therefore, allows the assessment of… Read more → Feasibility Adequate exercise When considering testing that includes an exercise component, it should be assumed that the patient has no limitations… Read more → Feasibility Cautionary condition The term "relative contraindications" was re-named "cautionary conditions". Read more →