Which test is most sensitive for detecting chronic coronary syndromes?

The most sensitive test for detecting chronic coronary syndromes is stress testing. This testing evaluates how well the heart functions under physical or pharmacological stress, simulating conditions similar to those encountered during physical activity. By assessing the heart's response, particularly in terms of ischemic changes or electrocardiographic abnormalities, stress tests can reveal the presence of coronary artery disease that may not be apparent at rest.

Stress testing can utilize exercise protocols or pharmacological agents, making it a versatile tool for understanding the functional capacity of the heart and the presence of significant coronary lesions. In contrast, other tests listed have varying roles in diagnosis but are not as sensitive in detecting chronic coronary syndromes. An electrocardiogram, while valuable for assessing heart rhythm and acute ischemic events, may not provide sufficient sensitivity for chronic conditions. A chest X-ray primarily evaluates structural abnormalities rather than functional heart assessment, and cardiac catheterization, while very informative, is an invasive procedure typically reserved for definitive diagnosis or intervention rather than initial screening. Thus, stress testing stands out as the most sensitive approach for detecting chronic coronary syndromes.