Recommendations from others
The American College of Cardiology7 gives a Class I recommendation (tests for which there is evidence or general agreement that a given procedure or treatment is useful and effective) for standard echocardiogram for evaluation of chest pain for patients with suspected acute myocardial ischemia (when baseline ECG and other laboratory markers are nondiagnostic and when the study can be obtained during pain or within minutes after its abatement).
It gives a Class IIa recommendation (tests for which there is conflicting evidence or divergence of opinion, but favoring usefulness) to stress echocardiography for the detection of myocardial ischemia for women with an intermediate pretest likelihood of coronary artery disease. It also gives a Class IIa recommendation to stress echocardiography for determining the prognosis of myocardial ischemia among patients for whom ECG assessment is less reliable. This group comprises patients with the following ECG abnormalities: pre-excitation syndrome (such as Wolff-Parkinson-White), electronically paced ventricular rhythm, more than 1 mm of ST depression at rest, and complete left bundle branch block.