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Investigation of Suspected CAD — EECC MCQ

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EasyCardiac ImagingInvestigation of Suspected CADEECC

A 60-year-old man presents with exertional chest pain. His pre-test probability of obstructive CAD is estimated at 15%. Which imaging investigation is most appropriate as the first-line test?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — CT coronary angiography

Explanation lettering: C = shown as A · D = shown as B · E = shown as C · B = shown as D · A = shown as E

Per the 2024 ESC CCS Guidelines, CTCA is recommended as first-line for patients with low clinical likelihood of obstructive CAD (PTP 5-15%) due to its high negative predictive value. Invasive angiography (A) is not first-line. Functional imaging (B, D, E) is preferred for intermediate-high PTP or when CTCA is inconclusive.

Reference: ESC (2024): Guidelines for the Management of Chronic Coronary Syndromes