Stress Testing and Advanced Imaging for Initial Diagnosis in Patients With Suspected SIHD Who Require Noninvasive Testing: Recommendations See Table 11 for a summary of recommendations from this section. 2.2.2.1. Able to Exercise Class I 1. Standard exercise ECG testing is recommended for patients with an intermediate pretest probability of IHD who have an interpretable ECG and at least moderate physical functioning or no disabling co- morbidity.114,145 147 (Level of Evidence: A) 2. Exercise stress with nuclear MPI or echocardiogra- phy is recommended for patients with an intermedi- ate to high pretest probability of IHD who have an uninterpretable ECG and at least moderate physical functioning or no disabling comorbidity.91,132,148 156 (Level of Evidence: B) Class IIa 1. For patients with a low pretest probability of ob- structive IHD who do require testing, standard exercise ECG testing can be useful, provided the patient has an interpretable ECG and at least mod- erate physical functioning or no disabling comorbid- ity. (Level of Evidence: C) 2. Exercise stress with nuclear MPI or echocardiogra- phy is reasonable for patients with an intermediate to high pretest probability of obstructive IHD who have an interpretable ECG and at least moderate physical functioning or no disabling comorbid- ity.91,132,148 156 (Level of Evidence: B) 3. Pharmacological stress with CMR can be useful for patients with an intermediate to high pretest prob- ability of obstructive IHD who have an uninterpre- table ECG and at least moderate physical function- ing or no disabling comorbidity.153,157,158 (Level of Evidence: B) Class IIb 1. CCTA might be reasonable for patients with an intermediate pretest probability of IHD who have at Fihn et al Stable Ischemic Heart Disease: Full Text e375 least moderate physical functioning or no disabling comorbidity.158 166 (Level of Evidence: B) 2. 