American Board of Internal Medicine (ABIM) Certification Practice Exam

For which group of patients is pharmacologic stress testing with imaging indicated?

1. Patients with high blood pressure

2. Patients unable to exercise

3. Patients with diabetes

4. Patients with a history of MI

The correct answer is: Patients unable to exercise

Pharmacologic stress testing with imaging is particularly indicated for patients who are unable to exercise. This form of testing serves as a valuable alternative for those individuals who, due to various medical conditions, physical limitations, or disabilities, cannot perform traditional exercise-based stress tests. By using pharmacologic agents such as dobutamine or adenosine, healthcare providers can simulate the physiological effects of exercise, allowing for the assessment of cardiac function and ischemia. In contrast, while patients with high blood pressure, diabetes, and those with a history of myocardial infarction may also require cardiac assessment, pharmacologic stress testing is specifically tailored for individuals who cannot exert themselves physically. These conditions can be evaluated through different means, including lifestyle adjustments, medication management, or regular monitoring, but they do not necessitate the specialized stress testing method in the same way that physical limitations do. Therefore, the use of pharmacologic stress testing with imaging becomes essential for accurate diagnosis and management in these patients.