Other, non-invasive tests are better used when the diagnosis or certainty of the diagnosis is not as clear.Indications for cardiac catheterization include the following:
Acute coronary syndromes: ST elevation MI (STEMI), non-ST Elevation MI (NSTEMI), and unstable angina
Evaluation of coronary artery disease as indicated by
Abnormal stress test
As part of the pre-op evaluation for other cardiac procedures (e.g., valve replacement) as coronary artery bypass grafting may be done at the same time
Risk stratification for high cardiac risk surgeries (e.g., endovascular aneurysm repair)
Persistent chest pain despite medical therapy thought to be cardiac in origin
New-onset unexplained heart failure
Survival of sudden cardiac death or dangerous cardiac arrhythmias
Workup of suspected Prinzmetal angina (coronary vasospasm)Right heart catheterization, along with pulmonary function testing and other testing should be done to confirm pulmonary hypertension prior to having vasoactive pharmacologic treatments approved and initiated. to measure intracardiac and intravascular blood pressures
to take tissue samples for biopsy
to inject various agents for measuring blood flow in the heart; also to detect and quantify the presence of an intracardiac shunt
to inject contrast agents in order to study the shape of the heart vessels and chambers and how they change as the heart beats

Pacemakers and defibrillators
Placement of internal pacemakers and defibrillators are done through catheterization as well. An exception to this is placement of electrodes on the outer surface of the heart (called epicardial electrodes). Otherwise, electrodes are placed through the venous system into the heart and left there permanently.
Seemingly surgery does not influence the high incidence of neurodevelopment problems in patients with metopic synostosis. Neurological disorders such as ADHD, ASD, ODD and CD are seen in patients with trigonocephaly. These disorders are usually also associated with decreased IQ. The presence of ADHD, ASD and ODD is higher in cases with an IQ below 85. This is not the case with CD which showed an insignificant increase at an IQ below 85. Epidemiology
The incidence of metopic synostosis is roughly between 1:700 and 1:15,000 newborns globally (differs per country). Trigonocephaly is seen more in males than females ranging from 2:1 to 6.5:1. Hereditary relations in metopic synostosis have been found of which 5.5% were well defined syndromic. Maternal age and a birth weight of less than 2500g may also play a role in trigonocephaly. These data are based on estimations and do not give factual information. Only one article gives valuable and reliable information regarding the incidence of metopic synostosis in the Netherlands. The incidence in the Netherlands showed an increase from 0.6 (1997) to 1.9 (2007) for every 10,000 live births. History
In former times people born with malformed skulls were rejected based upon their appearance. This still persists today in various parts of the world even though the intellectual development is often normal.