To the Editor In their Teachable Moment in a recent issue of JAMA Internal Medicine,1 Schmidt et al describe a case of a man in his late 60s with dyspnea on exertion referred for 3–vessel coronary artery bypass grafting surgery following a normal exercise stress echocardiogram due to overdiagnosis by coronary computed tomography angiography (CCTA) and cardiac catheterization. The authors correctly highlight 2 teachable moments: (1) the patient’s symptoms were unlikely to be from flow–limiting coronary artery disease (CAD); and (2) the patient should have been counselled about the role of medical therapy. However, the failure in this case was not because of the CCTA test, but rather because of how the treating physicians acted on the results of the test.
Avinainder Singh, Sanjay Divakaran, Ron Blankstein. Enhanced Education for Noninvasive Cardiac Testing. JAMA Intern Med. 2017;177(5):746. doi:10.1001/jamainternmed.2017.0768