Imaging recommendation · Cardiac

Stable exertional chest pain, low-to-intermediate risk

Q: What's the alternative imaging for stable exertional chest pain, low-to-intermediate risk when renal impairment / contrast concerns?

NM — Stress echo or MPI (iv contrast).

Recommended: Coronary CTA is the preferred imaging study for stable exertional chest pain, low-to-intermediate risk. Per AHA/ACC 2021 chest pain guideline.

Recommended study

Coronary CTA

CT IV contrast Preferred Cardiac OutpatientAcute inpatient Reviewed 2026-04

Per AHA/ACC 2021 chest pain guideline. Functional testing (stress echo or MPI) is a reasonable alternative.

If the default doesn't apply

Renal impairment / contrast concerns

NM Stress echo or MPI IV contrast