Prevalence
Clinical
features
Differential
diagnosis
Investigations
Therapy
Prevention
Prognosis
|  | | | Investigations |
Arrange stress testing on discharge or as an outpatient using any of
a
b
- scintigraphy
a
b
-
look for a reversible perfusion defect
b
Why?
Scintigraphy makes multivessel coronary artery disease more likely
| Patient |
Target Disorder and
Reference Standard |
Diagnostic Test |
LR+
(95% CI)
|
Post-test Probability |
LR-
(95% CI)
|
Post-test Probability |
chest pain referred for further investigation
(pre-test probability: 52%)
a
|
multivessel coronary artery disease
(coronary angiography)
|
scintigraphy
|
2.5
(1.5 to
4.2)
|
76% |
0.44
(0.29 to
0.67)
|
36% |
Scintigraphy : a reversible perfusion defect makes coronary artery disease more likely
| Patient b
|
Target Disorder and
Reference Standard |
Diagnostic Test |
LR+
(95% CI)
|
Post-test Probability |
suspected coronary artery disease
(pre-test probability: 51%)
|
coronary artery stenosis
(coronary angiography)
|
scintigraphy: reversible perfusion defect
|
12
|
93% |
|
|
|
fixed perfusion defect
|
1.4
|
59% |
|
|
|
no perfusion defect
|
0.18
|
16% |
Thallium scintigraphy can help diagnose
restenosis following PTCA
| Patient |
Target Disorder and
Reference Standard |
Diagnostic Test |
LR+
(95% CI) |
Post-test Probability |
LR-
(95% CI) |
Post-test Probability |
recent PTCA a
(pre-test probability: 51%) |
coronary artery re stenosis > 50%
(coronary angiography) |
scintigraphy |
3.9 |
80% |
0.16 |
14% |
|
internal medicine