| Modality | Strengths | Weaknesses |
| Myocardial perfusion scintigraphy | - Widely available
- Standard interpretive approaches, can be quantitated
- Images the process responsible for symptoms
- Multiple RCTs and observational data support use
| - Usually not available 24/7
- Rest imaging not as useful >~2 to 3 hours after symptoms but stress imaging is useful
- Entails radiation exposure
|
| Echocardiography | - Widely available
- Standard interpretive approaches
- Images a process associated with symptoms
- RCT and observational data support use
- Relatively low cost
| - May not be available 24/7
- Rest imaging not as useful after symptom cessation but stress imaging is useful
|
| Coronary CTA | - Widely available
- Standard qualitative interpretive approaches
- Images anatomy indirectly associated with symptoms
- Multiple RCTs and observational data support use
| - May not be available 24/7
- Coronary calcium may interfere with interpretation
- Implications of "moderate" stenoses or non-obstructive plaque not clear, patients would need further testing
- Some patients not eligible due to renal dysfunction. Fast heart rate, arrhythmias such as atrial fibrillation may be problematic with slower temporal resolution scanners. Entails radiation exposure
|
| Echocardiography with contrast for perfusion imaging | - Images the process responsible for symptoms
- Large observational data suggests incremental diagnostic information
| - Not available for general use - contrast agents for perfusion not FDA approved
- Interpretive approaches not standardized
- Most data come from specialized centers
|
| Cardiovascular MR | - Comprehensively images anatomy and physiology associated with symptoms (including myocardial perfusion, infarction, ventricular function)
- Small amount of observational data support use
| - Expertise for comprehensive imaging not widely available
- Interpretive approaches not standardized
- Data come from specialized centers
|
