Table 2.
Stress Test Modality | Diagnostic Criteria for Moderate or Severe Ischemia |
---|---|
Nuclear perfusion via SPECT or PET | ≥10% myocardium ischemic1 |
Echocardiography | ≥3/16 segments with stress-induced severe hypokinesis or akinesis |
Cardiac Magnetic Resonance | Perfusion: ≥12% myocardium ischemic, and/or Wall motion: ≥3/16 segments with stress-induced severe hypokinesis or akinesis |
Exercise Test without Imaging (criteria 1–3 must all be met) | 1. Absence of resting ST-segment depression ≥1.0 mm or confounders that render exercise ECG non-interpretable (LBBB, LVH with repolarization, pacemaker, etc.) |
2. As compared to the baseline tracing, additional exercise-induced horizontal or downsloping ST-segment depression ≥1.5 mm in 2 leads or ≥2.0 mm in any lead; ST-segment elevation ≥1mm in a non-infarct territory. Both the J-point and the ST-segment at 80 msec need to meet criteria. When the HR is >130/min, the ST-segment at 60 msec. may be used if the segment at 80 msec. cannot be determined. | |
3. Either of the following: a. Workload at which ST-segment criteria are met is not to exceed completion of stage 2 of a standard Bruce protocol or 7 METs if a non-Bruce protocol is used or b. ST segment criteria are met at <75% of the maximum predicted HR |