The Particulars: For patients with a normal baseline ECG who are referred for diagnostic stress testing, current guidelines recommend exercise ECG. Little is known about the added value and prognostic impact of myocardial perfusion single-photon emission (MPS) CT for detecting ischemia.

Data Breakdown: Data were analyzed on patients with a normal baseline ECG who underwent an exercise MPS in a study. MPS ischemia was found in 78% of patients with a positive ECG but only 7% off those with a negative ECG. Patients with MPS ischemia had significantly worse long-term survival but similar short-term survival, when compared with those with ECG ischemia. MPS ischemia was a significant predictor of mortality, whereas ECG ischemia was not.

Take Home Pearl: The addition of MPS in patients with normal baseline ECGs who are referred for stress testing appears to add to the specificity of ischemia detection.