A Coronary Angiogram is needed when a detailed image of the coronary arteries is needed.
Indications:
1. To Diagnose the cause of chest pain, if other tests such as ECG, Echo, stress testing, CTCA have not been conclusive
2. Prior to Valve surgery- to see if a coronary bypass is needed in addition to valve replacement
Three things may be found:
1. No disease at all- that is very reassuring- Normal coronary arteries
2. Mild disease- coronary atheroma- some furring up of the pipes, but not causing any significant blockages and no need for any stents or bypass. Sometimes a "Pressure Wire" is done to see if a narrowing is truely significant or not. This is akin to seeing if there is a significant drop in coronary pressure (fllow) beyond a narrowing.
3. Significant narrowings -Coronary Artery Stenosis. depending on the site and severity, then the best treatment could be:
--tablets only
--tablets plus stenting
--tablets plus coronary bypass surgery
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