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Clinical Practice
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Volume 349:465-473 July 31, 2003 Number 5
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Selecting Asymptomatic Patients for Coronary Computed Tomography or Electrocardiographic Exercise Testing
Philip Greenland, M.D., and J. Michael Gaziano, M.D., M.P.H.

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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors' clinical recommendations.

A healthy 40-year-old man exercises regularly, uses no tobacco, and has no cardiac symptoms. His blood pressure is 120/80 mm Hg, his total cholesterol concentration is 180 mg per deciliter (4.65 mmol per liter), his high-density lipoprotein (HDL) cholesterol concentration is 50 mg per deciliter (1.29 mmol per liter), his body-mass index (the weight in kilograms divided by the square of the . . . [Full Text of this Article]

The Clinical Problem

Strategies and Evidence

Calcium Scores Determined by Coronary CT

Electrocardiographic Exercise Testing

The Predictive Value of Screening Tests

Areas of Uncertainty

Guidelines

Recommendations and Conclusions


Source Information

From the Departments of Preventive Medicine and Medicine, Feinberg School of Medicine at Northwestern University, Chicago (P.G.); and the Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, and the Cooperative Studies Program, Veterans Affairs Boston Healthcare System (J.M.G.) — all in Boston.



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