Although only 2-D projection images are obtained (as opposed to 3-D volumes CCTA), selective coronary angiography is considered useful for depicting the anatomy and the severity of obstructive CAD and other coronary abnormalities (eg, coronary spasm, dissection, vasculitis) [8]. In addition to visualizing the coronary arteries, the procedure is used to guide percutaneous coronary interventions to Chronic Chest Pain-High Probability of CAD the site of blockage. LV catheterization and left ventriculography are generally indicated but not always necessary to define ventricular function in patients with known angina and IHD. FFR measurement accurately estimates the functional severity of stenosis in obstructive CAD [75-77]. The ISCHEMIA trial has shown that, among patients with stable coronary disease and moderate or severe ischemia, there was no evidence that an invasive diagnostic and therapeutic strategy, compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years [78,79]. CT Coronary Calcium There is no relevant literature to support the use of CT coronary calcium in the initial evaluation of patients with chronic chest pain and a high probability of CAD with known IHD. CT Heart Function and Morphology CT heart function and morphology can provide assessment of ventricular morphology and function as well as assessment of myocardial perfusion and infarction. There are no relevant data published on the use of CT heart for assessment of heart function and regional wall motion abnormalities in patients with chronic chest pain who have a high probability for CAD.
Chronic Chest Pain High Probability of Coronary Artery Disease PCAs. Although only 2-D projection images are obtained (as opposed to 3-D volumes CCTA), selective coronary angiography is considered useful for depicting the anatomy and the severity of obstructive CAD and other coronary abnormalities (eg, coronary spasm, dissection, vasculitis) [8]. In addition to visualizing the coronary arteries, the procedure is used to guide percutaneous coronary interventions to Chronic Chest Pain-High Probability of CAD the site of blockage. LV catheterization and left ventriculography are generally indicated but not always necessary to define ventricular function in patients with known angina and IHD. FFR measurement accurately estimates the functional severity of stenosis in obstructive CAD [75-77]. The ISCHEMIA trial has shown that, among patients with stable coronary disease and moderate or severe ischemia, there was no evidence that an invasive diagnostic and therapeutic strategy, compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years [78,79]. CT Coronary Calcium There is no relevant literature to support the use of CT coronary calcium in the initial evaluation of patients with chronic chest pain and a high probability of CAD with known IHD. CT Heart Function and Morphology CT heart function and morphology can provide assessment of ventricular morphology and function as well as assessment of myocardial perfusion and infarction. There are no relevant data published on the use of CT heart for assessment of heart function and regional wall motion abnormalities in patients with chronic chest pain who have a high probability for CAD.