Diagnosing Coronary Artery Disease in the Patient Presenting with Stable Ischemic Heart Disease The Role of Anatomic versus Functional Testing

The management of patients presenting with suspected stable coronary artery disease (CAD) can be challenging. The evaluation of such an individual includes assessment of his or her pretest probability, with a clinical history, followed by diagnostic testing where appropriate, to further risk stratify and define the extent of disease. This work-up requires identifying both the categorical classification of coronary disease (present vs absent) and, if coronary disease is present, the graded finding of functional disease severity. There are several options for evaluation, including functional stress testing with a variety of imaging modalities, or anatomic testing using diagnostic coronary angiography or coronary computed tomographic angiography (CCTA). In this article, we will