Cardiac Testing

CARDIAC TESTING FOR YOUR AT-RISK PATIENTS

You know a major threat to your at-risk patients is coronary artery disease (CAD). Learn more about how appropriate cardiac testing can help evaluate them. Here you'll find risk score calculators, modality information, and resources to help your patients when they need it most.

Patient Workup

Evaluate patient cardiovascular risk

Appropriate use Criteria

Learn about the CMS federal mandate

Noninvasive Cardiac Tests

Review cardiac testing options for at‑risk patients

Patient Education

Focus on what patients need to know

Library

Find further reading and resources

Event Registration

Attending a live educational event?

Calculator CMS Mandate

References

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Centers for Medicare & Medicaid Services. Medicare program; revisions to payment policies under the physician fee schedule and other revisions to Part B for CY 2018; Medicare Shared Savings Program requirements; and Medicare Diabetes Prevention Program; final rule. Fed Regist 2017;82(219):52976-3371.
Centers for Medicare & Medicaid Services. Appropriate Use Criteria Program (02-21-2019). https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Appropriate-Use-Criteria-Program/index.html. Accessed 8-08-2019.

Patient Workup

National Heart, Lung, and Blood Institute. Ischemic Heart Disease. https://www.nhlbi.nih.gov/health-topics/ischemic-heart-disease. Accessed 08-21-2019.
Fihn SD, Gardin JM, Abrams J, et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease. J Am Coll Cardiol 2012;60(24):e44-164. Erratum in: J Am Coll Cardiol 2014;63(15):1588-90.
Amsterdam EA, Wenger NK, Brindis RG, et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes. Circulation 2014;130(25):e344-426. Erratum in: Circulation 2014;130(25):e433-4.
National Heart, Lung, and Blood Institute. Risk Factors. https://www.nhlbi.nih.gov/health-topics/ischemic-heart-disease#risk-factors. Accessed 11-04-19.
Goff DC, Lloyd-Jones DM, Benett G, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk. Circulation 2014;129(25 Suppl 2):S49-73. Erratum in: J Am Coll Cardiol 2014;63(25 Pt B):3026.
American College of Cardiology. ASCVD risk estimator. http://tools.acc.org/ldl/ascvd_risk_estimator/index.html#!/calulate/estimator. Accessed 05-16-2019.
American College of Cardiology. ASCVD Risk Estimator. http://tools.acc.org/ldl/ascvd_risk_estimator/index.html#!/content/about/about-index. Accessed 12-20-2019.
American College of Cardiology. ASCVD Risk Estimator: About the Application (11-2018). http://tools.acc.org/ldl/ascvd_risk_estimator/index.html#!/content/about/about-index. Accessed 01-13-2020.
Pencina MJ, D'Agostino RB Sr, Larson MG, Massaro JM, Vasan RS. Predicting the 30-year risk of cardiovascular disease: the Framingham Heart Study. Circulation 2009;119(24):3078-84.
Ridker PM, Buring JE, Rifai N, Cook NR. Development and validation of improved algorithms for the assessment of global cardiovascular risk in women: the Reynolds Risk Score. JAMA 2007;297(6):611-9. Erratum in: JAMA 2007;297(13):1433.
Ridker PM, Paynter NP, Rifai N, Gaziano JM, Cook NR. C-reactive protein and parental history improve global cardiovascular risk prediction. Circulation 2008;118(22):2243-51.

Appropriate Use

Centers for Medicare & Medicaid Services. Appropriate Use Criteria Program (02-21-2019). https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment- Instruments/Appropriate-Use-Criteria-Program/index.html. Accessed 8-08-2019.
Centers for Medicare & Medicaid Services. Medicare program; revisions to payment policies under the physician fee schedule and other revisions to Part B for CY 2018; Medicare Shared Savings Program requirements; and Medicare Diabetes Prevention Program; final rule. Fed Regist 2017;82(219):52976-3371.
Centers for Medicare & Medicaid Services. Medicare program: revisions to payment policies under the physician fee schedule and other revisions to Part B for CY 2016; final rule with comment period. Fed Regist 2015;80(220):70885‐1386.
Centers for Medicare & Medicaid Services. Provider Led Entities (07-13-2017). https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Appropriate-Use-Criteria-Program/PLE.html. Accessed 06-08-2018.
Wolk MJ, Bailey SR, Doherty JU, et al. ACCF/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease. J Am Coll Cardiol 2014;63(4):380-406.
Centers for Medicare & Medicaid Services. Clinical Decision Support Mechanisms (03-30-2018). https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Appropriate-Use-Criteria-Program/CDSM.html. Accessed 06-07-2018.
Wennberg DE, Birkmeyer JD, eds; Dartmouth Atlas of Cardiovascular Health Care Working Group. The Dartmouth Atlas of Cardiovascular Health Care. Chicago, IL: AHA Press, 1999.
Miller ME. MedPAC Recommendations on Imaging Services (03-17-2005). https://www.aaos.org/Govern/public/Imaging/MedPAC_Imaging.pdf. Accessed 07-03-2018.
Medicare Payment Advisory Commission. Report to the Congress: Medicare Payment Policy (03-01-2019). http://www.medpac.gov/docs/default-source/reports/mar19_medpac_entirereport_sec.pdf?sfvrsn=0. Accessed 11-26-2019.
Hendel RC, Cerqueira M, Douglas PS, et al. A multicenter assessment of the use of single-photon emission computed tomography myocardial perfusion imaging with appropriateness criteria. J Am Coll Cardiol 2010;55(2):156-62.

Cardiac Tests

Fihn SD, Gardin JM, Abrams J, et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease. J Am Coll Cardiol 2012;60(24):e44-164. Erratum in: J Am Coll Cardiol 2014;63(15):1588-90.
American College of Cardiology. ASCVD Risk Estimator. http://tools.acc.org/ldl/ascvd_risk_estimator/index.html#!/calulate/estimator. Accessed 05-16-2019.
Wolk MJ, Bailey SR, Doherty JU, et al. ACCF/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease. J Am Coll Cardiol 2014;63(4):380-406.
Balady GJ, Morise AP. Exercise electrocardiographic testing. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald’s Heart Disease. 11th ed. Philadelphia, PA: Elsevier Saunders, 2019:154-73.
Shaw LJ, Peterson ED, Shaw LK, et al. Use of a prognostic treadmill score in identifying diagnostic coronary disease subgroups. Circulation 1998;98(16):1622-30.
Udelson JE, Dilsizian V, Bonow RO. Nuclear cardiology. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald’s Heart Disease. 11th ed. Philadelphia, PA: Elsevier Saunders, 2019:261-300.
American Society of Nuclear Cardiology, MedAxiom. 2013 nuclear cardiology trend survey. J Nucl Cardiol 2014;21(Suppl 1):5-88.
Henzlova MJ, Duvall WL, Einstein AJ, Travin MI, Verberne HJ. ASNC imaging guidelines for SPECT nuclear cardiology procedures. J Nucl Cardiol 2016;23(3):606-39. Erratum in: J Nucl Cardiol 2016;23(3):640-2.
Centers for Medicare & Medicaid Services. Medicare program: revisions to payment policies under the physician fee schedule and other revisions to Part B for CY 2016; final rule with comment period. Fed Regist 2015;80(220):70885‐1386.
American Heart Association. Single Photon Emission Computed Tomography (SPECT) (07- 31-2015). https://www.heart.org/en/health-topics/heart-attack/diagnosing-a-heart-attack/single-photon-emission-computed-tomography-spect. Accessed 11-21-2019.
National Heart, Lung, and Blood Institute. Echocardiography. https://www.nhlbi.nih.gov/health-topics/echocardiography. Accessed 11-14-2019.
Solomon SD, Wu JC, Gillam L. Echocardiography. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald’s Heart Disease. 11th ed. Philadelphia, PA: Elsevier Saunders, 2019:174-251.
Kwong RY. Cardiovascular magnetic resonance imaging. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald’s Heart Disease. 11th ed. Philadelphia, PA: Elsevier Saunders, 2019:301-20.

Patient Education

National Heart, Lung, and Blood Institute. Ischemic Heart Disease. https://www.nhlbi.nih.gov/health-topics/ischemic-heart-disease. Accessed 08-21-2019.
Fihn SD, Gardin JM, Abrams J, et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease. J Am Coll Cardiol 2012;60(24):e44-164. Erratum in: J Am Coll Cardiol 2014;63(15):1588-90.
American Heart Association. Atherosclerosis (04-30-2017). https://www.heart.org/en/health-topics/cholesterol/about-cholesterol/atherosclerosis. Accessed 11-21-2019.
National Heart, Lung, and Blood Institute. Risk Factors. https://www.nhlbi.nih.gov/health-topics/ischemic-heart-disease#risk-factors. Accessed 01-04-19.
Benjamin EJ, Muntner P, Alonso A, et al. Heart disease and stroke statistics—2019 update. Circulation 2019;139:e1-473.
Wolk MJ, Bailey SR, Doherty JU, et al. ACCF/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease. J Am Coll Cardiol 2014;63(4):380-406.
Henzlova MJ, Duvall WL, Einstein AJ, Travin MI, Verberne HJ. ASNC imaging guidelines for SPECT nuclear cardiology procedures. J Nucl Cardiol 2016;23(3):606-39. Erratum in: J Nucl Cardiol 2016;23(3):640-2.

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