Clinical overview of management of chronic ischemic heart disease.

The outcome of patients with chronic coronary artery disease is dependent on many factors; the most important ones include the severity and extent of coronary artery disease, state of left ventricular function at rest, extent and severity of myocardial ischemia, and the total amount of left ventricular myocardium that is at risk. To use noninvasive tests optimally, the clinician first must define the information needed. The sensitivity, specificity, and predictive accuracy of the test(s) in providing the necessary information, the additive value of the result of a test to the information already available, and the best combination of tests in providing the desired information help determine the choice of various noninvasive tests in a particular clinical circumstance.