Appendix B Visual representation of gatekeeper to functional imaging recommendation

This appendix is a flow chart of the proposed changes to the EST items described in section 4.4 of the report. It highlights the population subejct to the EST gatekeeper, those who have have atypical or uncertain symptoms that warrant investigation and an Absolute risk score of <10%.

1 Typical angina is all 3 of: constricting discomfort in the front of the chest, or in the neck, shoulders, jaw, or arms; AND precipitated by physical exertion; AND relieved by rest or GTN within about 5 minutes. Otherwise symptoms are atypical/uncertain.
2 Australian Absolute risk score, 5 year risk of cardiovascular event
3 Stress echo or MPS, considering cost, patient factors, local access and radiation exposure
4 Duke Treadmill Score