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This guideline presents the available evidence on the diagnosis of stable known or suspected ischemic heart disease (IHD). This is the first of 2 guidelines addressing stable IHD; the second guideline addresses the management of patients with stable IHD. Internists and other primary care physicians are the target audiences for this guideline. The target population is all adult patients with stable known or suspected IHD. These recommendations are based on the joint American College of Cardiology Foundation (ACCF), American Heart Association (AHA), American College of Physicians (ACP), American Association for Thoracic Surgery (AATS), Preventive Cardiovascular Nurses Association (PCNA), Society for Cardiovascular Angiography and Interventions (SCAI), and Society of Thoracic Surgeons (STS) guideline for the diagnosis and management of patients with stable IHD published in 2012, which ACP recognized as a scientifically valid, highquality review of the evidence (2). Full details about methods and evidence are available in the Appendix at http://www.annals.org.