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Home Chronic Chest Pain—High Probability of Coronary Artery Disease
Variants
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Chest pain, chronic, high probability of CAD, ischemic heart disease, no prior definitive treatment, initial imaging 3194883
US echocardiography transthoracic stress
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
Arteriography coronary
1-10 mSv
☢☢☢
Usually appropriate
MRI heart function and morphology without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function with stress without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function with stress without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CTA coronary arteries with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Rb-82 PET/CT heart
10-30 mSv
☢☢☢☢
Usually appropriate
SPECT or SPECT/CT MPI rest and stress
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually appropriate
US echocardiography transthoracic resting
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRI heart function and morphology without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT heart function and morphology with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US echocardiography transesophageal
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA coronary arteries without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA coronary arteries without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT coronary calcium
1-10 mSv
☢☢☢
Usually not appropriate
CTA chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA triple rule out
1-10 mSv
☢☢☢
Usually not appropriate
Nuclear medicine ventriculography
1-10 mSv
☢☢☢
Usually not appropriate