ESR Essentials: imaging in stable chest pain – practice recommendations by ESCR

Giuseppe Muscogiuri, Jonathan R. Weir-Mccall, Mariia Tregubova, Sebastian Ley, Christian Loewe, Hatem Alkadhi, Rodrigo Salgado, Rozemarijn Vliegenthart, Michelle C. Williams

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Stable chest pain is a common symptom with multiple potential causes. Non-invasive imaging has an important role in diagnosis and guiding management through the assessment of coronary stenoses, atherosclerotic plaque, myocardial ischaemia or infarction, and cardiac function. Computed tomography (CT) provides anatomical evaluation of coronary artery disease (CAD) with assessment of stenosis, plaque type and plaque burden, with additional functional information available from CT fractional flow reserve or CT myocardial perfusion imaging. Stress magnetic resonance imaging, nuclear stress myocardial perfusion imaging, and stress echocardiography can assess myocardial ischemia and other cardiac functional parameters. Coronary CT angiography can be used as a first line test for many patients with stable chest pain, particularly those with low to intermediate pre-test probability. Functional testing may be considered for patients with known CAD, where the clinical significance is uncertain based on anatomical testing, or in patients with high pre-test probability. This practice recommendations document can be used to guide the selection of non-invasive imaging for patients with stable chest pain and provides brief recommendations on how to perform and report these diagnostic tests.
Original languageEnglish
JournalEuropean Radiology
Publication statusPublished - 16 Apr 2024


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