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. For patients with a low pretest probability of ob- structive IHD who do require testing, standard exercise stress echocardiography might be reason- able, provided the patient has an interpretable ECG and at least moderate physical functioning or no disabling comorbidity. (Level of Evidence: C) Class III: No Benefit 1. Pharmacological stress with nuclear MPI, echocar- diography, or CMR is not recommended for patients who have an interpretable ECG and at least moder- ate physical functioning or no disabling comorbid- ity.155,167,168 (Level of Evidence: C) 2. Exercise stress with nuclear MPI is not recom- mended as an initial test in low-risk patients who have an interpretable ECG and at least moderate physical functioning or no disabling comorbidity. (Level of Evidence: C) 2.2.2.2. Unable to Exercise Class I 1. Pharmacological stress with nuclear MPI or echo- cardiography is recommended for patients with an intermediate to high pretest probability of IHD who are incapable of at least moderate physical function- ing or have disabling comorbidity.148 150,152 156 (Level of Evidence: B) Class IIa 1. Pharmacological stress echocardiography is reason- able for patients with a low pretest probability of Table 11. 