Would it be reasonable to refer an otherwise healthy patient in their 40s for LHC after CCTA findings note significant proximal RCA stenosis, which was obtained following a transient episode of resting substernal chest pain but without subsequent reproducible symptoms with exercise?

Answer from: at Community Practice

I would favor a nuclear stress test to see if the lesion was associated with myocardial ischemia during exercise. If there was substantial evidence of ischemia, then I would proceed to LHC. If minimal or no myocardial ischemia, I would proceed with aggressive medical and lifestyle therapy.

Comments

at Kaiser Permanente Panorama City Medical Center
This is a lesion in the RCA per CTA. Nuclear stres...

at Methodist Cardiology Clinic Of San Antonio Westover Hills
Cardiac PET, when available, has superior spatial ...

at The George Washington University Hospital
Far too much faith in Nuclear stress. Patient need...

at Washington University School of Medicine
Shared decision-making is needed here. If the pati...

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Would it be reasonable to refer an otherwise healthy patient in their 40s for LHC after CCTA findings note significant proximal RCA stenosis, which was obtained following a transient episode of resting substernal chest pain but without subsequent reproducible symptoms with exercise?

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