For patients with high-risk stress test features with ischemic EKG changes and mild to no symptoms, what would be your threshold to directly admit them for coronary angiography, or pursue outpatient elective coronary angiogram?   

The key is whether there is a stable clinical history. In the absence of any symptoms suggesting a change in clinical trajectory, the evaluation should be done without a direct admission particularly in order to allow patients to plan rather than create a sense of emergency. Unprovoked symptoms that...