Which test is commonly used to assess ischemia in suspected unstable angina?

Which test is commonly used to assess ischemia in suspected unstable angina?

• A. Coronary angiography
• B. Exercise stress test / Nuclear Stress Test
• C. Echocardiography at rest
• D. Holter monitoring

Answer: (B)

Ischemia is best detected by showing how the heart handles increased demand. After initial stabilization in suspected unstable angina, a noninvasive stress test with imaging evaluates for inducible ischemia. An exercise treadmill test with nuclear perfusion imaging measures blood flow to the heart muscle during exercise; areas with reduced perfusion indicate ischemia from underlying coronary obstruction. Nuclear imaging improves sensitivity by separately assessing perfusion, not just electrical activity. This test helps risk-stratify patients and decide between medical therapy or further invasive evaluation. Resting echocardiography can show wall-motion abnormalities but does not assess ischemia under stress, coronary angiography reveals anatomy without functional ischemia, and Holter monitoring detects arrhythmias rather than ischemia.

Ischemia is best detected by showing how the heart handles increased demand. After initial stabilization in suspected unstable angina, a noninvasive stress test with imaging evaluates for inducible ischemia. An exercise treadmill test with nuclear perfusion imaging measures blood flow to the heart muscle during exercise; areas with reduced perfusion indicate ischemia from underlying coronary obstruction. Nuclear imaging improves sensitivity by separately assessing perfusion, not just electrical activity. This test helps risk-stratify patients and decide between medical therapy or further invasive evaluation. Resting echocardiography can show wall-motion abnormalities but does not assess ischemia under stress, coronary angiography reveals anatomy without functional ischemia, and Holter monitoring detects arrhythmias rather than ischemia.