The American College of Cardiology and the American Heart Association (ACC/AHA) updated guidelines for the management of patients with stable chest pain syndromes and known or suspected ischemic heart disease in 2002.^[1] Populations addressed by these guidelines include patients with “ischemic equivalents” such as dyspnea or arm pain with exertion and patients with ischemic heart disease who have become asymptomatic, including those who have undergone revascularization procedures. Patients with unstable ischemic syndromes are not included in these guidelines but are instead addressed in guidelines summarized in  Chap. 53 Guidelines. As with other ACC/AHA guidelines, indications for interventions are classified into the following four groups:

		Class I—for generally accepted indications
		Class IIa—when indications are controversial, but the weight of evidence is supportive
		Class IIb—when usefulness or efficacy is less well …