When Should Patients with Chest Pain Be Referred for Coronary Angiography?

Abstract

When evaluating patients with possible coronary artery disease, it is necessary to combine physiologic assessment (measurements of ischemia) with anatomic pathologic assessment (coronary angiography). Coronary angiography currently is the only way to assess the anatomic pathology of the coronary circulation with precision. When it is combined with ventriculography and tests for myocardial ischemia, one can make clinical decisions related to the significance of the coronary artery disease observed. Common sense really demands that coronary angiography is only indicated when the information derived from this diagnostic procedure will facilitate therapeutic decisions in the individual patient.