Risk Assessment in Patients Able to Exercise Class I 1. Standard exercise ECG testing is recommended for risk assessment in patients with SIHD who are able to exercise to an adequate workload and have an interpretable ECG.106 110,112 114,132 134 (Level of Evi- dence: B) 2. The addition of either nuclear MPI or echocardiog- raphy to standard exercise ECG testing is recom- mended for risk assessment in patients with SIHD who are able to exercise to an adequate workload but have an uninterpretable ECG not due to LBBB or ventricular pacing.7,111,264 266,270,299,300 (Level of Evidence: B) Class IIa 1. The addition of either nuclear MPI or echocardi- ography to standard exercise ECG testing is rea- sonable for risk assessment in patients with SIHD who are able to exercise to an adequate workload and have an interpretable ECG.271 279 (Level of Evidence: B) 2. CMR with pharmacological stress is reasonable for risk assessment in patients with SIHD who are able to exercise to an adequate workload but have an uninterpretable ECG.279 284 (Level of Evidence: B) Class IIb 1. CCTA may be reasonable for risk assessment in patients with SIHD who are able to exercise to an adequate workload but have an uninterpretable ECG.285,286 (Level of Evidence: B) Class III: No Benefit 1. Pharmacological stress imaging (nuclear MPI, echocardiography, or CMR) or CCTA is not rec- ommended for risk assessment in patients with SIHD who are able to exercise to an adequate workload and have an interpretable ECG. (Level of Evidence: C) 3.2.2.2. Risk Assessment in Patients Unable to Exercise Class I 1. 