Detection and management of the asymptomatic XXXX with coronary artery disease.

@entity1 @entity308 @entity1242 @entity3362 @entity943
A clinician is faced with several dilemmas when evaluating the asymptomatic individual. The first dilemma relates to 'who should be evaluated'. Generally the first step in evaluation is the exercise stress test (fig. 2). The following are guidelines that can be used to systematically evaluate the individual asymptomatic @entity1 who presents with a 'positive exercise stress test' (fig. 3). An ambulatory ECG can be performed to evaluate the occurrence and frequency of asymptomatic @entity308 and the response to @entity3362 . Isotope angiography and exercise 201Tl perfusion studies may provide additional information relating to the physiologic significance of asymptomatic @entity308 . If these studies are negative and the @entity1 ' 'positive stress test' was obtained at a high cardiac workload coupled with rapid normalization of the ST segment after exercise, and there was no change in the @entity308 after @entity1242 , a reasonable case can be made to simply observe the @entity1 . If the exercise test is 'positive' at a low cardiac workload, associated with prolonged @entity308 and/or a 'positive' exercise thallium or positive exercise angiography, or there was change in the @entity308 after @entity1242 or a lifethreatening @entity943 developed, coronary angiography seems warranted.
