Coronary Angiography

The history, technic, and complications of coronary angiography have been discussed. Myocardial infarction caused by the procedure occurs in 0.3-0.9% of all cases. Two leading groups report an incidence of 1/1000 to 1/2500 deaths related to the procedure. Angiographic anatomy has been described. Indications for the procedure are: intractable angina in patients with or without a history of myocardial infarction and unexplained left ventricular failure or failure due to a left ventricular aneurysm. Among the debatable indications are: unexplained ECG changes, aortic valve disease, preinfarction patterns, cardiogenic shock, and follow-up angiograms after bypass surgery. If immediate surgery is not contemplated, left ventricular failure and a recent myocardial infarction are contraindication to the procedure. The limitations of the procedure are the radiographic resolution and the inconsistent anatomic pattern of minor vessels.