|Indication||Test||Class||Level of Evidence|
|1. Assessment of myocardial risk in possible ACS patients with nondiagnostic ECG and initial serum markers and enzymes, if available.||Rest MPI||I||A|
|2. Diagnosis of CAD in possible ACS patients with chest pain with nondiagnostic ECG and negative serum markers and enzymes or normal resting scan.||Same day rest/stress perfusion imaging||I||B|
|3. Routine imaging of patients with myocardial ischemia/necrosis already documented clinically, by ECG and/or serum markers or enzymes||Rest MPI||III||C|
See Figure 6 of ACC/AHA 2002 Guideline Update for the Management of Patients With Unstable Angina and Non-ST-Segment Elevation Myocardial Infarction at http://www.acc.org/clinical/guidelines/unstable/incorporated/figure6.htmand Figure 1 of ACC/AHA Guidelines for the Management of Patients with Acute Myocardial Infarction at www.acc.org/clinical/guidelines/nov96/1999/jac1716f01.htm.
ACS indicates acute coronary syndromes; CAD, coronary artery disease; ECG, electrocardiogram; MPI, myocardial perfusion imaging.