Which is better at diagnosing coronary artery disease- stress tests or coronary angiogram?
It really depends on the situation. A heart cath, although a very safe test, is an invasive procedure. A non-invasive test like a stress test is usually preferable screening test. However, there are several scenarios where a heart cath is considered first choice for the diagnosis of coronary artery disease. Isnt coronary angiogram a gold standard? The coronary angiogram gives us an anatomical description of coronary arteries. The anatomy, unlike biochemistry or physiology lends itself to concrete mental grasp. It is also likely to be interpreted in a somewhat similar fashion by different observers. Notice the tight spot marked by an arrow. The extent of narrowing is estimated based on the appearance of adjacent area. Picture from texasheart.org The coronary angiogram has some shortcomings including: – The coronary angiogram is a two dimensional picture. The inner lumen of the artery may be significantly diseased without showing obvious abnormalities on the two dimensional pictures. – C
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