Coronary Angiography and Revascularization

Indications for coronary angiography in stable CAD, asx Pts, and others

  • CCS class III–IV angina despite med Rx, angina + systolic dysfxn, or unexplained low EF
  • High-risk stress test findings (qv) or uncertain dx after noninv testing (& info will ∆ mgmt)
  • Occupational need for definitive dx (eg, pilot) or inability to undergo noninvasive testing
  • Survivor of SCD, polymorphic VT, sustained monomorphic VT
  • Suspected spasm; nonathero cause of ischemia (eg, anomalous coronary; CCTA preferred)
  • Preop workup in select Pts undergoing organ transplant eval (CCTA reasonable)

Precath checklist & periprocedural pharmacotherapy

  • Peripheral emoral, DP, PT pulses; bruits); ✓ palmar arch intact (eg, w/ pulse oximetry & plethysmography). ✓ can lie flat, NPO >6 h.