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This study of 15 077 patients undergoing stress echo found that pts with concordant negative findings (stress EKG negative and stress ECHO negative) were at lowest risk. Those with discordant findings (+ EKG but neg ECHO) were at intermediate risk. Those with a positive ECHO were at highest risk. Comment: The composite outcome was total mortality, MI, unstable angina, and revascularization. For this endpoint a double negative test had a 8.5% risk, those with discordant findings almost double the risk (14.6%), and those with a positive ECHO again had about double the risk (37.4%). So, low risk (double negative) had about a 1 in 12 risk, intermediate risk (discordant findings) had about a 1 in 6 risk, and high risk (positive ECHO) had about a 1 in 3 risk of a major adverse cardiac event. JAMA Intern Med. 2020 Jan 27.    (retrieved Feb, 2020). There are currently 1090 pearls in the database. While every attempt has been made to ensure accuracy, mistakes can and do occur. Use databank at your own risk. All pearls © 2024 by the Internet Medical Association. Click Here to view more medical pearls.